Lmna gene and its involvement in hutchinson-gilford progeria syndrome (hgps) and arteriosclerosis

ABSTRACT

Disclosed herein are point mutations in the LMNA gene that cause HGPS. These mutations activate a cryptic splice site within the LMNA gene, which leads to deletion of part of exon 11 and generation of a mutant Lamin A protein product that is 50 amino acids shorter than the normal protein. In addition to the novel Lamin A variant protein and nucleic acids encoding this variant, methods of using these molecules in detecting biological conditions associated with a LMNA mutation in a subject (e.g., HGPS, arteriosclerosis, and other age-related diseases), methods of treating such conditions, methods of selecting treatments, methods of screening for compounds that influence Lamin A activity, and methods of influencing the expression of LMNA or LMNA variants are also described. Oligonucleotides and other compounds for use in examples of the described methods are also provided, as are protein-specific binding agents, such as antibodies, that bind specifically to at least one epitope of a Lamin A variant protein preferentially compared to wildtype Lamin A, and methods of using such antibodies in diagnosis, treatment, and screening. Also provided are kits for carrying out the methods described herein.

CROSS REFERENCE TO RELATED APPLICATIONS

This is a divisional of co-pending U.S. application Ser. No. 14/025,497,filed Sep. 12, 2013; which is a continuation of U.S. application Ser.No. 13/229,441, filed Sep. 9, 2011, which issued as U.S. Pat. No.8,535,884 on Sep. 17, 2013; which is a continuation of U.S. applicationSer. No. 11/870,234, filed Oct. 10, 2007, which issued as U.S. Pat. No.8,034,557 on Oct. 11, 2011; which is a divisional of U.S. applicationSer. No. 10/943,400, filed Sep. 17, 2004, which issued as U.S. Pat. No.7,297,492 on Nov. 20, 2007; which is a continuation ofPCT/US2003/0033058, filed Oct. 17, 2003; which in turn claims thebenefit of U.S. Provisional Application 60/463,084, filed Apr. 14, 2003,and of U.S. Provisional Application 60/419,541, filed Oct. 18, 2002. Allof these applications are incorporated herein in their entirety.

FIELD OF THE DISCLOSURE

This disclosure relates to genetic bases of aging, and more particularlyto the gene LMNA, which encodes Lamin A/C, and its involvement in agingphenomena including the disease referred to as Hutchinson-GilfordProgeria Syndrome (HGPS).

BACKGROUND OF THE DISCLOSURE

The prospect of reversing senescence and restoring the proliferativepotential of cells has implications in many fields of endeavor. Many ofthe diseases of old age are associated with the loss of this potential.Moreover, the tragic disease, Progeria, which is often described in theliterature as a premature aging syndrome based on appearance, isassociated with the loss of proliferative potential of cells. WernerSyndrome and Hutchinson-Gilford Progeria Syndrome (HGPS) are twoprogeroid diseases. A major clinical difference between the two is thatthe onset of Hutchinson-Gilford Progeria Syndrome (sometimes calledprogeria of childhood) occurs within the first decade of life, whereasthe first evidence of Werner Syndrome (sometimes called progeria ofadulthood) appears only after puberty, with the full symptoms becomingmanifest in individuals 20 to 30 years old.

More particularly, Hutchinson-Gilford Progeria Syndrome (HGPS) (alsoreferred to as Hutchinson-Gilford Syndrome or Progeria) is a very rareprogressive disorder of childhood characterized by features of prematureaging (progeria), failure to thrive usually beginning in the first yearof life resulting in short stature and low weight, deterioration of thelayer of fat beneath the skin (subcutaneous adipose tissue), andcharacteristic craniofacial abnormalities, including frontal bossing,underdeveloped jaw (micrognathia), unusually prominent eyes and/or asmall, “beak-like” nose. In addition, during the first year or two oflife, scalp hair, eyebrows and eyelashes may become sparse, and veins ofthe scalp may become unusually prominent. Additional symptoms andphysical findings may include joint stiffness, repeated nonhealingfractures, a progressive aged appearance of the skin, delays in tootheruption (dentition) and/or malformation and crowding of the teeth.Individuals with the disorder typically have normal intelligence. Inmost cases, affected individuals experience premature, widespreadthickening and loss of elasticity of artery walls (arteriosclerosis),often resulting in life-threatening complications such as heart attacksand strokes which are the usual causes of death.

HGPS is thought to be a genetic disorder, yet the mode of inheritance,molecular basis, and pathogenic mechanism all remain elusive. It has inthe past been thought to be due to a sporadic autosomal dominant geneticmutation.

The identification of mutations associated with HGPS would be anincredible breakthrough in detection, diagnosis, and prognosis of thisdisease, and would open avenues for treatment and possibly prevention ofHGPS and related or similar conditions, including more generallyarteriosclerosis and aging.

SUMMARY OF THE DISCLOSURE

Surprisingly, point mutations have been identified in the LMNA gene thatcause HGPS. The inheritance is new mutation autosomal dominant, andidentified mutations occur in codon 608; the most common is due to a Cto T base substitution in a CpG dinucleotide. It is currently believedthat the mechanism of the mutations is activation of a cryptic splicesite within the LMNA gene, which leads to deletion of part of exon 11and generation of a Lamin A protein product that is 50 amino acidsshorter than the normal protein. All of the identified mutations arepredicted to affect Lamin A but not Lamin C. In addition, two cases ofsegmental UPD from fibroblast DNA do not show the mutation, which may beindicative of a (in vivo or in vitro) somatic rescue event.

Thus, this disclosure provides a novel Lamin A variant protein, andnucleic acids encoding this variant. Also disclosed are methods of usingthese molecules in detecting biological conditions associated with aLMNA mutation in a subject (e.g., HGPS, arteriosclerosis, and otherage-related diseases), methods of treating such conditions, methods ofselecting treatments (e.g., agents that promote mitotic crossing overand thereby somatic rescue events), methods of screening for compoundsthat influence Lamin A activity, and methods of influencing theexpression of LMNA or LMNA variants. Oligonucleotides and othercompounds for use in examples of such methods are also provided.

Also disclosed herein are protein-specific binding agents, such asantibodies, that bind specifically to at least one epitope of a Lamin Avariant protein preferentially compared to wildtype Lamin A, and methodsof using such antibodies in diagnosis, treatment, and screening.

Kits are also provided for carrying out the methods described herein.

The foregoing and other features and advantages will become moreapparent from the following detailed description of several embodiments,which proceeds with reference to the accompanying figures.

BRIEF DESCRIPTION OF THE FIGURES

FIG. 1A shows a marker comparison between two HGPS cases that wereidentified with segmental uniparental isodisomy (UPD) of chromosome 1q.A subset of markers and their genotypes are shown. More than 100chromosome 1q specific microsatellite markers have been analyzed, withan average spacing of 1.75 cM. As illustrated, every marker on the q armbetween at least marker 1q22 and marker 1q44 showed homozygosity. SKYand G-banding showed a normal karyotype for these individuals and therewere no other regions of homozygosity on the other chromosomes whichrules out the possibility of consanguinity. NA indicates sample notavailable.

FIG. 1B is the karyotype described by Brown et al. (ASHG Abstract,1990), which illustrates the karyotyping of an individual (sample C8803)with a more severe form of HGPS. The subject was mosaic for a balancedinverted insertion on chromosome 1q.

FIG. 1C illustrates the genotyping pedigree for proband C8803 (anothersample ID for this patient is AG10548), which showed a paternal deletionof approximately 6 Mb between 1q21.3 and 1q23.1. A subset of informativemarkers and their genotypes in the region of the paternal deletion areshown. The boxed interval is the region that has been inheritedexclusively from the mother. Though the sample was mosaic for achromosome rearrangement (earlier reported by T. Brown et al., ASHGAbstract, 1990), the deletion appeared to affect 100% of the cells.

FIG. 1D shows a FISH hybridization analysis of a metaphase spread fromC8803 fibroblasts, using a BAC probe within the deletion interval. Thismetaphase is from one of the cells in the mosaic sample that wassupposedly karyotypically normal, but it clearly shows complete deletionof the BAC signal on one of the chromosomes 1.

FIG. 1E is a map of the paternal deletion region on 1q21.3-q23.2,observed in sample C8803. Microsatellite markers are indicated witharrows; the markers that define the maximal deletion region in C8803 areD1S2346 and D1S2635. The thick short horizontal lines indicate BACprobes that were used for FISH on sample C8803. RP1-140J1 andRP11-137M19 fall outside the deletion region, whereas the other BACs arewithin it. Combining the information from this deletion with theboundary of one of the cases of UPD, the candidate interval for the HGPSgene can be delimited to 4.82 Mb. LMNA is one of the ˜80 known genes inthis interval.

The identified deleted region contains approximately 80 genes, one ofwhich is LMNA (encoding Lamin A/C), which is illustrated.

FIG. 2A is a series of sequencing results, illustrating heterozygotebase substitutions in LMNA. The top sequence trace shows the normalsequence surrounding codon 608 of LMNA; the middle trace is the sameregion in one of the HGPS samples; the third panel shows the sequencetrace from sample AG10801. Heterozygote nucleotides are indicated withan N.

FIG. 2B illustrates the mechanism of activation of a cryptic splicedonor site in exon 11, which occurs in the two mutations codon 608identified herein. These mutations (designated as Mutation 1 andMutation 2 in the figure) activate a cryptic splice site within exon 11,thereby altering the structure of the resultant protein while seeminglyappearing “silent” on first examination. The consensus sequence for asplice donor is as listed at the top of the figure.

The normal sequence, which is also the sequence that was found in allthe unaffected first degree relatives, shows two mismatches to theconsensus splice sequence. Mutation 1, which is the more common of thetwo mutations identified to date, changes this sequence to just onemismatch. Mutation 2 does the same, by altering the other nucleotide.

Activation of the cryptic splice site within exon 11 results in part ofexon 11 being deleted from the mRNA sequence. Exon 12 is still in frame,so the resulting Lamin A protein has an internal deletion of exactly 50amino acids.

FIG. 2C is a picture of a DNA gel, showing the results of an RT-PCRexperiment on representative samples. The normal product is seen at 639bp, but a product of 489 bp is also seen in the two HGPS probands(AG03506 and AG10801), due to activation of the cryptic splice site.Alternate lanes contain RT-PCR product from controls using no reversetranscriptase.

FIG. 3 is a Western blot using a monoclonal antibody against Lamin A/C.Protein samples originating from EBV-transformed lymphoblastoid celllines are in the first five lanes. Protein samples originating fromprimary dermal fibroblasts are in the next four lanes. The samplesmarked “AG03505 father” and “AG03504 mother” are derived from theparents of the HGPS sample AG03506. A protein sample from HeLa cells wasused as positive control; the slightly different migration of Lamin Aand Lamin C in this lane is presumed to be due to a difference inpost-translational modification.

FIG. 4 (including FIG. 4A-4G) is a series of micrographs, illustratingimmunofluorescence on primary dermal fibroblasts from an unaffectedmother and child with classical HGPS, using antibody JOL2 against LaminA/C. Identical results were obtained with antibody XB10. FIG. 4A-4D showresults from an unaffected mother, AG06299. FIG. 4E-4H show results froma classical HGPS patient, AG11498. In FIGS. 4A and 4E, the antibody isagainst Lamin A/C. In FIGS. 4B and 4F, the cells are DAPI stained,showing location of the nuclei. In FIGS. 4C and 4B, the antibody stainsmitochondria, showing distribution of the cytosol. FIG. 4D is a mergedimage of FIG. 4A-4C. FIG. 4H is a merged image of FIG. 4E-4G.

FIGS. 5A and 5B provides two schematic representations of the LMNA geneencoding Lamin A and Lamin C proteins, showing position ofdisease-causing mutations (FIGS. 5A and 5B) and the schematic structureof the protein (FIG. 5A).

The LMNA gene has 12 exons, which are shown here as boxes. The predictedstructural motifs of lamin A are shown as two globular domains, one atthe N- and one at the C-terminus, with a central coiled-coil regionlinking the two (FIG. 5A).

The figure shows the exons affected by disease rather than theindividual mutations. Mutations causing autosomal dominantEmery-Dreifuss muscular dystrophy (AD-EDMD) occur along the length ofthe LMNA gene. Mutations causing dilated cardiomyopathy (DCM) have beenfound in exons 1, 3, 6, 8, 10 and 11; mutations linked with familialDunnigan-type partial lipodystrophy (FPLD) occur in exons 8 and 11;mutations linked with limb-girdle muscular dystrophy 1B (LGMD-1B) occurin exons 3, 6 and 10; and one mutation linked to Charcot-Marie-Toothdisorder type 2 (AR-CMT2) occurs in exon 5. There is also amandibuloacral dysplasia recessive mutation in exon 9.

BRIEF DESCRIPTION OF THE SEQUENCES

The nucleic and amino acid sequences listed herein are shown usingstandard letter abbreviations for nucleotide bases, and three lettercode for amino acids, as defined in 37 C.F.R. 1.822. Only one strand ofeach nucleic acid sequence is shown, but the complementary strand isunderstood as included by any reference to the displayed strand. TheSequence Listing is submitted as an ASCII text file namedSeqList-66648-13.txt, created on Jul. 9, 2015, ˜48 KB, which isincorporated by reference herein. In the accompanying sequence listing:

SEQ ID NO: 1 shows the nucleic acid sequence and deduced amino acidsequence of normal (wildtype) LMNA. This sequence is derived fromAH001498, but modified according to Fisher et al. (PNAS USA, 83:6450-6454, 1986) at codon positions 555 and 556; the corrected cDNAsequences are also shown in GenBank Accession Nos. NM_(—)170707 (LaminA) and NM_(—)005572 (Lamin C). The genomic DNA sequence and mRNAsequence (exon 3-12) of LMNA are shown in GI 292250 (same as accessionnumber L12401). In addition, all of the LMNA exons (1, 2, and 3-12) aswell as 5′ and 3′ UTRs are found in Accession No. AH001498.

SEQ ID NO: 2 shows the amino acid sequence of the normal Lamin Aprotein.

SEQ ID NO: 3 shows the nucleic acid sequence of normal exon 11 of LMNA.

SEQ ID NO: 4 shows the nucleic acid sequence of exon 11 of LMNA withMutation 1 (also referred to as G608G(GGC>GGT)).

SEQ ID NO: 5 shows the nucleic acid sequence of exon 11 of LMNA withMutation 2 (also referred to as G608S(GGC>AGC)).

SEQ ID NO: 6 shows the predicted cDNA (and deduced amino acid sequenceencoded thereby) resulting from intron/exon processing of eitherMutation 1 (G608G(GGC>GGT)) and Mutation 2 (G608S(GGC>AGC)), which leadto the same predicted mutant cDNA sequence. This sequence lacks 150nucleotides of the wildtype LMNA cDNA that are spliced away due to theactivation of a cryptic splice site within exon 11.

SEQ ID NO: 7 shows the amino acid sequence of mutant Lamin A proteinencoded by the cDNA in either Mutation 1 or Mutation 2 samples. Thisprotein is 50 amino acids shorter than the normal Lamin A, shown in SEQID NO: 2.

SEQ ID NOs: 8-57 show the nucleic acid sequence of primers used foranalysis of microsatellite markers on chromosome 1q21.3-23.1 (asdescribed in Table 1):

SEQ ID NOs: 58-63 show the nucleic acid sequence of primers used formutation analysis of LMNA.

SEQ ID NOs: 64 and 65 show the nucleic acid sequence of primers used forRT-PCR analysis of exon 11.

SEQ ID NO: 66 is the CAAX box motif of the prelamin protein.

DETAILED DESCRIPTION I. Abbreviations

ASO: allele-specific oligonucleotide

ASOH: allele-specific oligonucleotide hybridization

DASH: dynamic allele-specific hybridization

DEXA: dual energy X-ray absorptiometry

HGPS: Hutchinson-Gilford Progeria Syndrome

RT-PCR: reverse-transcription polymerase chain reaction

II. Terms

Unless otherwise noted, technical terms are used according toconventional usage. Definitions of common terms in molecular biology maybe found in Benjamin Lewin, Genes V, published by Oxford UniversityPress, 1994 (ISBN 0-19-854287-9); Kendrew et al. (eds.), TheEncyclopedia of Molecular Biology, published by Blackwell Science Ltd.,1994 (ISBN 0-632-02182-9); and Robert A. Meyers (ed.), Molecular Biologyand Biotechnology: a Comprehensive Desk Reference, published by VCHPublishers, Inc., 1995 (ISBN 1-56081-569-8). A comprehensive discussionof aspects of Hutchinson-Gilford Progeria syndrome and terms relevant tothis syndrome can be found, for instance, in DeBusk (J. Pediatrics,80:697-724, 1974).

In order to facilitate review of the various embodiments of theinvention, the following non-limiting explanations of specific terms areprovided:

Abnormal: Deviation from normal characteristics. Normal characteristicscan be found in a control, a standard for a population, etc. Forinstance, where the abnormal condition is a disease condition, such asprogeria, a few appropriate sources of normal characteristics mightinclude an individual who is not suffering from the disease (e.g.,progeria), a population standard of individuals believed not to besuffering from the disease, etc.

Likewise, abnormal may refer to a condition that is associated with adisease. The term “associated with” includes an increased risk ofdeveloping the disease as well as the disease itself. For instance, acertain abnormality (such as an abnormality in an LMNA nucleic acid orLamin protein expression) can be described as being associated with thebiological conditions of progeria and tendency to develop prematureaging disease or condition.

An abnormal nucleic acid, such as an abnormal LMNA nucleic acid, is onethat is different in some manner to a normal (wildtype) nucleic acid.Such abnormality includes but is not necessarily limited to: (1) amutation in the nucleic acid (such as a point mutation (e.g., a singlenucleotide polymorphism) or short deletion or duplication of a few toseveral nucleotides); (2) a mutation in the control sequence(s)associated with that nucleic acid such that replication or expression ofthe nucleic acid is altered (such as the functional inactivation of apromoter); (3) a decrease in the amount or copy number of the nucleicacid in a cell or other biological sample (such as a deletion of thenucleic acid, either through selective gene loss or by the loss of alarger section of a chromosome or under expression of the mRNA); (4) anincrease in the amount or copy number of the nucleic acid in a cell orsample (such as a genomic amplification of part or all of the nucleicacid or the overexpression of an mRNA), each compared to a control orstandard; and (5) an alteration in a sequence that controls the splicingmechanism, in such a way that either a normal splice signal isinactivated or an abnormal splice signal is created. It will beunderstood that these types of abnormalities can co-exist in the samenucleic acid or in the same cell or sample; for instance, agenomic-amplified nucleic acid sequence may also contain one or morepoint mutations. In addition, it is understood that an abnormality in anucleic acid may be associated with, and in fact may cause, anabnormality in expression of the corresponding protein.

Abnormal protein expression, such as abnormal Lamin A proteinexpression, refers to expression of a protein that is in some mannerdifferent to expression of the protein in a normal (wildtype) situation.This includes but is not necessarily limited to: (1) a mutation in theprotein such that one or more of the amino acid residues is different;(2) a short deletion or addition of one or a few amino acid residues tothe sequence of the protein; (3) a longer deletion or addition of aminoacid residues, such that an entire protein domain or sub-domain isremoved or added; (4) expression of an increased amount of the protein,compared to a control or standard amount; (5) expression of a decreasedamount of the protein, compared to a control or standard amount; (6)alteration of the subcellular localization or targeting of the protein;(7) alteration of the temporally regulated expression of the protein(such that the protein is expressed when it normally would not be, oralternatively is not expressed when it normally would be); and (8)alteration of the localized (e.g., organ or tissue specific) expressionof the protein (such that the protein is not expressed where it wouldnormally be expressed or is expressed where it normally would not beexpressed), each compared to a control or standard.

Controls or standards appropriate for comparison to a sample, for thedetermination of abnormality, include samples believed to be normal aswell as laboratory values, even though possibly arbitrarily set, keepingin mind that such values may vary from laboratory to laboratory.Laboratory standards and values may be set based on a known ordetermined population value and may be supplied in the format of a graphor table that permits easy comparison of measured, experimentallydetermined values.

Antisense, Sense, and Antigene: Double-stranded DNA (dsDNA) has twostrands, a 5′→3′ strand, referred to as the plus strand, and a 3′→5′strand (the reverse complement), referred to as the minus strand.Because RNA polymerase adds nucleic acids in a 5′→3′ direction, theminus strand of the DNA serves as the template for the RNA duringtranscription. Thus, the RNA formed will have a sequence complementaryto the minus strand and identical to the plus strand (except that U issubstituted for T).

Antisense molecules are molecules that are specifically hybridizable orspecifically complementary to either RNA or the plus strand of DNA.Sense molecules are molecules that are specifically hybridizable orspecifically complementary to the minus strand of DNA. Antigenemolecules are either antisense or sense molecules directed to a dsDNAtarget.

Binding or stable binding (of an oligonucleotide): An oligonucleotidebinds or stably binds to a target nucleic acid if a sufficient amount ofthe oligonucleotide forms base pairs or is hybridized to its targetnucleic acid, to permit detection of that binding. Binding can bedetected by either physical or functional properties of thetarget:oligonucleotide complex. Binding between a target and anoligonucleotide can be detected by any procedure known to one skilled inthe art, including both functional and physical binding assays. Bindingmay be detected functionally by determining whether binding has anobservable effect upon a biosynthetic process such as expression of agene, DNA replication, transcription, translation and the like.

Physical methods of detecting the binding of complementary strands ofDNA or RNA are well known in the art, and include such methods as DNAseI or chemical footprinting, gel shift and affinity cleavage assays,Northern blotting, dot blotting and light absorption detectionprocedures. For example, one method that is widely used, because it isso simple and reliable, involves observing a change in light absorptionof a solution containing an oligonucleotide (or an analog) and a targetnucleic acid at 220 to 300 nm as the temperature is slowly increased. Ifthe oligonucleotide or analog has bound to its target, there is a suddenincrease in absorption at a characteristic temperature as theoligonucleotide (or analog) and target disassociate from each other, ormelt.

The binding between an oligomer and its target nucleic acid isfrequently characterized by the temperature (T_(m)) at which 50% of theoligomer is melted from its target. A higher (T_(m)) means a stronger ormore stable complex relative to a complex with a lower (T_(m)).

cDNA (complementary DNA): A piece of DNA lacking internal, non-codingsegments (introns) and transcriptional regulatory sequences. cDNA mayalso contain untranslated regions (UTRs) that are responsible fortranslational control in the corresponding RNA molecule. cDNA is usuallysynthesized in the laboratory by reverse transcription from messengerRNA extracted from cells.

Complementarity and percentage complementarity: Molecules withcomplementary nucleic acids form a stable duplex or triplex when thestrands bind, (hybridize), to each other by forming Watson-Crick,Hoogsteen or reverse Hoogsteen base pairs. Stable binding occurs when anoligonucleotide remains detectably bound to a target nucleic acidsequence under the required conditions.

Complementarity is the degree to which bases in one nucleic acid strandbase pair with the bases in a second nucleic acid strand.Complementarity is conveniently described by percentage, e.g. theproportion of nucleotides that form base pairs between two strands orwithin a specific region or domain of two strands. For example, if 10nucleotides of a 15-nucleotide oligonucleotide form base pairs with atargeted region of a DNA molecule, that oligonucleotide is said to have66.67% complementarity to the region of DNA targeted.

A thorough treatment of the qualitative and quantitative considerationsinvolved in establishing binding conditions that allow one skilled inthe art to design appropriate oligonucleotides for use under the desiredconditions is provided by Beltz et al. Methods Enzymol 100:266-285,1983, and by Sambrook et al. (ed.), Molecular Cloning: A LaboratoryManual, 2nd ed., vol. 1-3, Cold Spring Harbor Laboratory Press, ColdSpring Harbor, N. Y., 1989.

DNA (deoxyribonucleic acid): DNA is a long chain polymer which comprisesthe genetic material of most living organisms (some viruses have genescomprising ribonucleic acid (RNA)). The repeating units in DNA polymersare four different nucleotides, each of which comprises one of the fourbases, adenine, guanine, cytosine and thymine bound to a deoxyribosesugar to which a phosphate group is attached. Triplets of nucleotides(referred to as codons) code for each amino acid in a polypeptide, orfor a stop signal. The term codon is also used for the corresponding(and complementary) sequences of three nucleotides in the mRNA intowhich the DNA sequence is transcribed.

Unless otherwise specified, any reference to a DNA molecule is intendedto include the reverse complement of that DNA molecule. Except wheresingle-strandedness is required by the text herein, DNA molecules,though written to depict only a single strand, encompass both strands ofa double-stranded DNA molecule. Thus, a reference to the nucleic acidmolecule that encodes Lamin A, or a fragment thereof, encompasses boththe sense strand and its reverse complement. Thus, for instance, it isappropriate to generate probes or primers from the reverse complementsequence of the disclosed nucleic acid molecules.

Deletion: The removal of a sequence of DNA, the regions on either sideof the removed sequence being joined together.

Epitope tags are short stretches of amino acids to which a specificantibody can be raised, which in some embodiments allows one tospecifically identify and track the tagged protein that has been addedto a living organism or to cultured cells. Detection of the taggedmolecule can be achieved using a number of different techniques.Examples of such techniques include: immunohistochemistry,immunoprecipitation, flow cytometry, immunofluorescence microscopy,ELISA, immunoblotting (“Western”), and affinity chromatography. Examplesof useful epitope tags include FLAG, T7, HA (hemagglutinin) and myc. TheFLAG tag was used in some particular examples disclosed herein becausehigh quality reagents are available to be used for its detection.

Genomic target sequence: A sequence of nucleotides located in aparticular region in the human genome that corresponds to one or morespecific genetic abnormalities, such as a nucleotide polymorphism, adeletion, or an amplification. The target can be for instance a codingsequence; it can also be the non-coding strand that corresponds to acoding sequence.

Hybridization: Oligonucleotides and their analogs hybridize by hydrogenbonding, which includes Watson-Crick, Hoogsteen or reversed Hoogsteenhydrogen bonding, between complementary bases. Generally, nucleic acidconsists of nitrogenous bases that are either pyrimidines (cytosine (C),uracil (U), and thymine (T)) or purines (adenine (A) and guanine (G)).These nitrogenous bases form hydrogen bonds between a pyrimidine and apurine, and the bonding of the pyrimidine to the purine is referred toas “base pairing.” More specifically, A will hydrogen bond to T or U,and G will bond to C. “Complementary” refers to the base pairing thatoccurs between to distinct nucleic acid sequences or two distinctregions of the same nucleic acid sequence. For example, anoligonucleotide can be complementary to a Lamin A encoding mRNA, or aLamin A-encoding dsDNA.

“Specifically hybridizable” and “specifically complementary” are termsthat indicate a sufficient degree of complementarity such that stableand specific binding occurs between the oligonucleotide (or its analog)and the DNA or RNA target. The oligonucleotide or oligonucleotide analogneed not be 100% complementary to its target sequence to be specificallyhybridizable. An oligonucleotide or analog is specifically hybridizablewhen binding of the oligonucleotide or analog to the target DNA or RNAmolecule interferes with the normal function of the target DNA or RNA,and there is a sufficient degree of complementarity to avoidnon-specific binding of the oligonucleotide or analog to non-targetsequences under conditions where specific binding is desired, forexample under physiological conditions in the case of in vivo assays orsystems. Such binding is referred to as specific hybridization.

Hybridization conditions resulting in particular degrees of stringencywill vary depending upon the nature of the hybridization method ofchoice and the composition and length of the hybridizing nucleic acidsequences. Generally, the temperature of hybridization and the ionicstrength (especially the Na⁺ concentration) of the hybridization bufferwill determine the stringency of hybridization, though waste times alsoinfluence stringency. Calculations regarding hybridization conditionsrequired for attaining particular degrees of stringency are discussed bySambrook et al. (ed.), Molecular Cloning: A Laboratory Manual, 2nd ed.,vol. 1-3, Cold Spring Harbor Laboratory Press, Cold Spring Harbor, N.Y., 1989, chapters 9 and 11, herein incorporated by reference.

For purposes of the present disclosure, “stringent conditions” encompassconditions under which hybridization will only occur if there is lessthan 25% mismatch between the hybridization molecule and the targetsequence. “Stringent conditions” may be broken down into particularlevels of stringency for more precise definition. Thus, as used herein,“moderate stringency” conditions are those under which molecules withmore than 25% sequence mismatch will not hybridize; conditions of“medium stringency” are those under which molecules with more than 15%mismatch will not hybridize, and conditions of “high stringency” arethose under which sequences with more than 10% mismatch will nothybridize. Conditions of “very high stringency” are those under whichsequences with more than 6% mismatch will not hybridize.

Isolated: An “isolated” biological component (such as a nucleic acidmolecule, protein or organelle) has been substantially separated orpurified away from other biological components in the cell of theorganism in which the component naturally occurs, e.g., otherchromosomal and extra-chromosomal DNA and RNA, proteins and organelles.Nucleic acids and proteins that have been “isolated” include nucleicacids and proteins purified by standard purification methods. The termalso embraces nucleic acids and proteins prepared by recombinantexpression in a host cell as well as chemically synthesized nucleicacids.

Nucleotide: “Nucleotide” includes, but is not limited to, a monomer thatincludes a base linked to a sugar, such as a pyrimidine, purine orsynthetic analogs thereof, or a base linked to an amino acid, as in apeptide nucleic acid (PNA). A nucleotide is one monomer in apolynucleotide. A nucleotide sequence refers to the sequence of bases ina polynucleotide.

Oligonucleotide: An oligonucleotide is a plurality of joined nucleotidesjoined by native phosphodiester bonds, between about 6 and about 300nucleotides in length. An oligonucleotide analog refers to moieties thatfunction similarly to oligonucleotides but have non-naturally occurringportions. For example, oligonucleotide analogs can contain non-naturallyoccurring portions, such as altered sugar moieties or inter-sugarlinkages, such as a phosphorothioate oligodeoxynucleotide. Functionalanalogs of naturally occurring polynucleotides can bind to RNA or DNA,and include peptide nucleic acid (PNA) molecules.

Particular oligonucleotides and oligonucleotide analogs can includelinear sequences up to about 200 nucleotides in length, for example asequence (such as DNA or RNA) that is at least 6 bases, for example atleast 8, 10, 15, 20, 25, 30, 35, 40, 45, 50, 100 or even 200 bases long,or from about 6 to about 50 bases, for example about 10-25 bases, suchas 12, 15 or 20 bases.

Operably linked: A first nucleic acid sequence is operably linked with asecond nucleic acid sequence when the first nucleic acid sequence isplaced in a functional relationship with the second nucleic acidsequence. For instance, a promoter is operably linked to a codingsequence if the promoter affects the transcription or expression of thecoding sequence. Generally, operably linked DNA sequences are contiguousand, where necessary to join two protein-coding regions, in the samereading frame.

Open reading frame: A series of nucleotide triplets (codons) coding foramino acids without any internal termination codons. These sequences areusually translatable into a peptide.

Parenteral: Administered outside of the intestine, e.g., not via thealimentary tract. Generally, parenteral formulations are those that willbe administered through any possible mode except ingestion. This termespecially refers to injections, whether administered intravenously,intrathecally, intramuscularly, intraperitoneally, or subcutaneously,and various surface applications including intranasal, intradermal, andtopical application, for instance.

Peptide Nucleic Acid (PNA): An oligonucleotide analog with a backbonecomprised of monomers coupled by amide (peptide) bonds, such as aminoacid monomers joined by peptide bonds.

Pharmaceutically acceptable carriers: The pharmaceutically acceptablecarriers useful with this disclosure are conventional. Martin,Remington's Pharmaceutical Sciences, published by Mack Publishing Co.,Easton, Pa., 19th Edition, 1995, describes compositions and formulationssuitable for pharmaceutical delivery of the nucleotides and proteinsherein disclosed.

In general, the nature of the carrier will depend on the particular modeof administration being employed. For instance, parenteral formulationsusually comprise injectable fluids that include pharmaceutically andphysiologically acceptable fluids such as water, physiological saline,balanced salt solutions, aqueous dextrose, glycerol or the like as avehicle. For solid compositions (e.g., powder, pill, tablet, or capsuleforms), conventional non-toxic solid carriers can include, for example,pharmaceutical grades of mannitol, lactose, starch, or magnesiumstearate. In addition to biologically-neutral carriers, pharmaceuticalcompositions to be administered can contain minor amounts of non-toxicauxiliary substances, such as wetting or emulsifying agents,preservatives, and pH buffering agents and the like, for example sodiumacetate or sorbitan monolaurate.

Polymorphism: Variant in a sequence of a gene. Polymorphisms can bethose variations (nucleotide sequence differences) that, while having adifferent nucleotide sequence, produce functionally equivalent geneproducts, such as those variations generally found between individuals,different ethnic groups, geographic locations. The term polymorphismalso encompasses variations that produce gene products with alteredfunction, e.g., variants in the gene sequence that lead to gene productsthat are not functionally equivalent. This term also encompassesvariations that produce no gene product, an inactive gene product, orincreased gene product. The term polymorphism may be usedinterchangeably with allele or mutation, unless context clearly dictatesotherwise.

Polymorphisms can be referred to, for instance, by the nucleotideposition at which the variation exists, by the change in amino acidsequence caused by the nucleotide variation, or by a change in someother characteristic of the nucleic acid molecule that is linked to thevariation (e.g., an alteration of a secondary structure such as astem-loop, or an alteration of the binding affinity of the nucleic acidfor associated molecules, such as polymerases, RNases, and so forth). Inthe current instance, Mutation 1 is also referred to as G608G(GGC>GGT),indicating that the mutation is in codon 608, that it is silent (in thatit causes no change in the encoded amino acid), and that the exactnucleotide sequence change is C to T in the third position of the codon.Similarly, Mutation 2 is also referred to as G608S(GGC>AGC), indicatingthat the mutation is in codon 608, that it causes an amino acidsubstitution (glycine to serine), and that the exact nucleotide sequencechange is G to A in the first position of the codon.

Probes and primers: A probe comprises an isolated nucleic acid attachedto a detectable label or other reporter molecule. Typical labels includeradioactive isotopes, enzyme substrates, co-factors, ligands,chemiluminescent or fluorescent agents, haptens, and enzymes. Methodsfor labeling and guidance in the choice of labels appropriate forvarious purposes are discussed, e.g., in Sambrook et al. (In MolecularCloning: A Laboratory Manual, CSHL, New York, 1989) and Ausubel et al.(In Current Protocols in Molecular Biology, John Wiley & Sons, New York,1998).

Primers are short nucleic acid molecules, for instance DNAoligonucleotides 10 nucleotides or more in length, for example thathybridize to contiguous complementary nucleotides or a sequence to beamplified. Longer DNA oligonucleotides may be about 15, 20, 25, 30 or 50nucleotides or more in length. Primers can be annealed to acomplementary target DNA strand by nucleic acid hybridization to form ahybrid between the primer and the target DNA strand, and then the primerextended along the target DNA strand by a DNA polymerase enzyme. Primerpairs can be used for amplification of a nucleic acid sequence, e.g., bythe polymerase chain reaction (PCR) or other nucleic-acid amplificationmethods known in the art. Other examples of amplification include stranddisplacement amplification, as disclosed in U.S. Pat. No. 5,744,311;transcription-free isothermal amplification, as disclosed in U.S. Pat.No. 6,033,881; repair chain reaction amplification, as disclosed in WO90/01069; ligase chain reaction amplification, as disclosed in EP-A-320308; gap filling ligase chain reaction amplification, as disclosed inU.S. Pat. No. 5,427,930; and NASBA™ RNA transcription-freeamplification, as disclosed in U.S. Pat. No. 6,025,134.

Nucleic acid probes and primers can be readily prepared based on thenucleic acid molecules provided in this disclosure. It is alsoappropriate to generate probes and primers based on fragments orportions of these disclosed nucleic acid molecules, for instance regionsthat encompass the identified polymorphisms at nucleotide 1822 andnucleotide 1824 within the LMNA coding sequence.

Methods for preparing and using nucleic acid probes and primers aredescribed, for example, in Sambrook et al. (In Molecular Cloning: ALaboratory Manual, CSHL, New York, 1989), Ausubel et al. (ed.) (InCurrent Protocols in Molecular Biology, John Wiley & Sons, New York,1998), and Innis et al. (PCR Protocols, A Guide to Methods andApplications, Academic Press, Inc., San Diego, Calif., 1990).Amplification primer pairs can be derived from a known sequence, forexample, by using computer programs intended for that purpose such asPrimer (Version 0.5, © 1991, Whitehead Institute for BiomedicalResearch, Cambridge, Mass.). One of ordinary skill in the art willappreciate that the specificity of a particular probe or primerincreases with its length. Thus, for example, a primer comprising 30consecutive nucleotides of a Lamin A-encoding nucleotide or flankingregion thereof (a “Lamin A primer” or “Lamin A probe”) will anneal to atarget sequence with a higher specificity than a corresponding primer ofonly 15 nucleotides. Thus, in order to obtain greater specificity,probes and primers can be selected that comprise at least 20, 25, 30,35, 40, 45, 50 or more consecutive nucleotides of a Lamin A nucleotidesequences.

The disclosure thus includes isolated nucleic acid molecules thatcomprise specified lengths of the Lamin A encoding sequence and/orflanking regions. Such molecules may comprise at least 10, 15, 20, 23,25, 30, 35, 40, 45 or 50 consecutive nucleotides of these sequences ormore, and may be obtained from any region of the disclosed sequences. Byway of example, the human LMNA locus, cDNA, ORF, coding sequence andgene sequences (including sequences both upstream and downstream of theLMNA coding sequence) may be apportioned into about halves or quartersbased on sequence length, and the isolated nucleic acid molecules (e.g.,oligonucleotides) may be derived from the first or second halves of themolecules, or any of the four quarters. The cDNA also could be dividedinto smaller regions, e.g. about eighths, sixteenths, twentieths,fiftieths and so forth, with similar effect.

In particular embodiments, isolated nucleic acid molecules comprise oroverlap at least one residue position designated as being associatedwith a polymorphism that is predictive of progeria and/or a prematureaging disease or condition. Such polymorphism sites include position1822 (corresponding to the Mutation 2 polymorphism) and position 1824(corresponding to the Mutation 1 polymorphism).

Protein: A biological molecule, particularly a polypeptide, expressed bya gene and comprised of amino acids.

Purified: The term “purified” does not require absolute purity; rather,it is intended as a relative term. Thus, for example, a purified proteinpreparation is one in which the protein referred to is more pure thanthe protein in its natural environment within a cell or within aproduction reaction chamber (as appropriate).

Recombinant: A recombinant nucleic acid is one that has a sequence thatis not naturally occurring or has a sequence that is made by anartificial combination of two otherwise separated segments of sequence.This artificial combination can be accomplished by chemical synthesisor, more commonly, by the artificial manipulation of isolated segmentsof nucleic acids, e.g., by genetic engineering techniques.

Representational difference analysis: A PCR-based subtractivehybridization technique used to identify differences in the mRNAtranscripts present in closely related cell lines.

Serial analysis of gene expression: The use of short diagnostic sequencetags to allow the quantitative and simultaneous analysis of a largenumber of transcripts in tissue, as described in Velculescu et al.(Science 270:484-487, 1995).

Specific binding agent: An agent that binds substantially only to adefined target. Thus a Lamin A protein-specific binding agent bindssubstantially only the Lamin A protein. As used herein, the term “Laminprotein specific binding agent” includes anti-Lamin protein antibodies(and functional fragments thereof) and other agents (such as solublereceptors) that bind substantially only to a Lamin protein. It isparticularly contemplated in specific embodiments that certainLamin-specific binding agents are specific for one form of Lamin, suchas Lamin A or Lamin C.

Anti-Lamin protein antibodies may be produced using standard proceduresdescribed in a number of texts, including Harlow and Lane (Antibodies, ALaboratory Manual, CSHL, New York, 1988). The determination that aparticular agent binds substantially only to the target protein mayreadily be made by using or adapting routine procedures. One suitable invitro assay makes use of the Western blotting procedure (described inmany standard texts, including Harlow and Lane (Antibodies, A LaboratoryManual, CSHL, New York, 1988)). Western blotting may be used todetermine that a given target protein binding agent, such as ananti-Lamin A protein monoclonal antibody, binds substantially only tothe specified target protein.

Shorter fragments of antibodies can also serve as specific bindingagents. For instance, FAbs, Fvs, and single-chain Fvs (SCFvs) that bindto Lamin A would be Lamin A-specific binding agents. These antibodyfragments are defined as follows: (1) FAb, the fragment which contains amonovalent antigen-binding fragment of an antibody molecule produced bydigestion of whole antibody with the enzyme papain to yield an intactlight chain and a portion of one heavy chain; (2) FAb′, the fragment ofan antibody molecule obtained by treating whole antibody with pepsin,followed by reduction, to yield an intact light chain and a portion ofthe heavy chain; two FAb′ fragments are obtained per antibody molecule;(3) (FAb′) 2, the fragment of the antibody obtained by treating wholeantibody with the enzyme pepsin without subsequent reduction; (4)F(Ab′)2, a dimer of two FAb′ fragments held together by two disulfidebonds; (5) Fv, a genetically engineered fragment containing the variableregion of the light chain and the variable region of the heavy chainexpressed as two chains; and (6) single chain antibody (“SCA”), agenetically engineered molecule containing the variable region of thelight chain, the variable region of the heavy chain, linked by asuitable polypeptide linker as a genetically fused single chainmolecule. Methods of making these fragments are routine.

Subject: Living multi-cellular vertebrate organisms, a category thatincludes both human and non-human mammals. This term encompasses bothknown and unknown individuals, such that there is no requirement that aperson working with a sample from a subject know who the subject is, oreven from where the sample was acquired.

Target sequence: “Target sequence” is a portion of ssDNA, dsDNA or RNAthat, upon hybridization to a therapeutically effective oligonucleotideor oligonucleotide analog, results in the inhibition of expression. Forexample, hybridization of therapeutically effectively oligonucleotide toan LMNA target sequence results in inhibition of Lamin A expression.Either an antisense or a sense molecule can be used to target a portionof dsDNA, since both will interfere with the expression of that portionof the dsDNA. The antisense molecule can bind to the plus strand, andthe sense molecule can bind to the minus strand. Thus, target sequencescan be ssDNA, dsDNA, and RNA.

Transformed: A transformed cell is a cell into which has been introduceda nucleic acid molecule by molecular biology techniques. As used herein,the term transformation encompasses all techniques by which a nucleicacid molecule might be introduced into such a cell, includingtransfection with viral vectors, transformation with plasmid vectors,and introduction of naked DNA by electroporation, lipofection, andparticle gun acceleration.

Vector: A nucleic acid molecule as introduced into a host cell, therebyproducing a transformed host cell. A vector may include nucleic acidsequences that permit it to replicate in a host cell, such as an originof replication. A vector may also include one or more selectable markergenes and other genetic elements known in the art.

Unless otherwise explained, all technical and scientific terms usedherein have the same meaning as commonly understood by one of ordinaryskill in the art to which this invention belongs. The singular terms“a,” “an,” and “the” include plural referents unless context clearlyindicates otherwise. Similarly, the word “or” is intended to include“and” unless the context clearly indicates otherwise. Hence “comprisingA or B” means including A, or B, or A and B. It is further to beunderstood that all base sizes or amino acid sizes, and all molecularweight or molecular mass values, given for nucleic acids or polypeptidesare approximate, and are provided for description. Although methods andmaterials similar or equivalent to those described herein can be used inthe practice or testing of the present invention, suitable methods andmaterials are described below. All publications, patent applications,patents, and other references mentioned herein are incorporated byreference in their entirety. In case of conflict, the presentspecification, including explanations of terms, will control. Inaddition, the materials, methods, and examples are illustrative only andnot intended to be limiting.

III. Hutchinson-Gilford Progeria Syndrome

Hutchinson-Gilford Progeria Syndrome (HGPS, OMIM #176670) is anextremely rare premature aging syndrome affecting approximately one in 8million live births (DeBusk, J Pediat. 80:697-724, 1972). This disorderis also commonly referred to as “progeria,” or “progeria of childhood”.The clinical features are remarkably reproducible. Typically affectedchildren appear normal at birth, but within a year the characteristicfeatures of failure to thrive, delayed dentition, alopecia, andsclerodermatous skin changes begin to appear. Children typically exhibitnormal intelligence, very short stature, poor weight gain, andincomplete sexual maturation. Death occurs on average at age 13, and atleast 90% of the patients die from progressive atherosclerosis of thecoronary and cerebrovascular arteries (Baker et al., Arch. Pathol. Lab.Med. 105:384-386, 1981; Shozawa et al., Acta Pathol. Jpn. 34:797-811,1984). Though commonly referred to as a premature aging syndrome, someof the features of the normal aging process (such as cataracts,Alzheimer's disease, and presbyopia) are not observed in patients withHGPS.

The inheritance pattern has not previously been known, since nearly allcases appear sporadic. In favor of a sporadic dominant mutation as thecause are reports of a modest paternal age effect, the paucity ofaffected sibpairs (even in very large sibships), and the limited reportsof known consanguinity (Jones et al., J Pediatr. 86:84-88, 1975; Brown,Mech. Aging. Dev. 9:325-336, 1979; and Brown et al., “Progeria: agenetic disease model of premature aging.” In Genetic Effects on AgingII (ed. Harrison, D. E.) 521-542, The Telford Press, Inc., Caldwell,N.J., 1990). It is believed that the known consanguinity rate does notexceed the rate in the general population. In favor of a recessivemutation are the rare reports of affected sibpairs (Franklyn, Clin.Radiol. 27:327-333, 1976; Trevas-Maciel, Am. J. Med. Genet. 31:483-487,1988; Khalifa, Clin. Genet. 35:125-132, 1989; Parkash et al., Am. J.Med. Genet. 36:431-433, 1990), though some have argued that those casesdo not represent classic Progeria, but are rather instances of a relateddisease such as mandibuloacral dysplasia (Schrander-Stumpel et al., Am.J. Med. Genet. 43:877-881, 1992).

IV. Lamin A

Lamins, members of the intermediate filament family of proteins, arecomponents of the nuclear lamina, a fibrous layer on the nucleoplasmicside of the inner nuclear membrane, which is thought to provide aframework for the nuclear envelope and may also interact with chromatin.Lamin A and C are present in roughly equal amounts in the lamina ofmammals. Lamin A/C are products of the same locus, LMNA, and aregenerated by alternative splicing of the same original transcript. LaminA consists of exons 1-12, while Lamin C consists of exons 1-10. A splicesite within exon 10, which is upstream of the stop codon for Lamin C,splices together with exon 11 in Lamin A. The last six amino acids ofLamin C are not present in Lamin A.

As illustrated in FIG. 5, part of exon 1 of LMNA encodes the N-terminalglobular domain, the rest of exon 1 through to part of exon 7 encodesthe central helical domain, and the rest of exon 7 to 12 encodes theC-terminus of lamin A. Lamin C has a similar structure, but is shorterat the C-terminus, which is encoded by exons 7 to 10. The elongatedC-terminus of lamin A bears a terminal tetrapeptide sequence known asthe CaaX (SEQ ID NO: 66) motif (where C is cysteine, “a” is any aminoacid bearing an aliphatic side-chain and X is any amino acid). Thismotif is the site of post-translational addition of a hydrophobicisoprene (farnesyl) group, which allows it to be incorporated into theinner nuclear membrane. Following membrane localization, the CaaX (SEQID NO: 66) motif and its contiguous 18 residues are removed byproteolytic cleavage, yielding the mature form of lamin A. The shorterC-terminus of lamin C does not undergo these post-translationalmodifications and its integration into the inner nuclear membrane isdependent upon association with lamin A.

The structural integrity of the lamina is strictly controlled by thecell cycle, as seen by the disintegration and formation of the nuclearenvelope in prophase and telophase, respectively. Increasedphosphorylation of the lamins occurs before envelope disintegration andprobably plays a role in regulating lamin associations.

V. Disease Previously Linked to Lamin A/C

Defects in LMNA are a cause of Emery-Dreifuss muscular dystrophy (EDMD;e.g., associated with heterozygous R527P), an autosomal recessive ordominant disease characterized by muscle weakness, contractures, andcardiomyopathy with conduction defects. In addition, defects in LMNA area cause of dilated cardiomyopathy 1a (CMD1A; e.g., associated withR644C). Further, defects in LMNA are a cause of familial partiallipodystrophy (Dunnigan variety) (FPLD), an autosomal dominant disordercharacterized by marked loss of subcutaneous adipose tissue from theextremities and trunk but by excess fat deposition in the head and neck.This condition is frequently associated with profound insulinresistance, dyslipidemia, and diabetes. Very recently specific mutationsin LMNA have been identified in patients with the recessive diseasemandibuloacral dysplasia (e.g., associated with homozygous R527H).

VI. The Involvement of Lamin A in HGPS, Arteriosclerosis and Aging

Surprisingly, point mutations have been identified in the LMNA gene thatcause HGPS. The inheritance is new mutation autosomal dominant, andidentified mutations occur in codon 608; the most common is due to a Cto T base substitution in a CpG dinucleotide. It is currently believedthat the mechanism of the mutations is activation of a cryptic splicesite within the LMNA gene, which leads to deletion of part of exon 11and generation of a Lamin A protein product that is 50 amino acidsshorter than the normal protein. All of the identified mutations arepredicted to affect Lamin A but not Lamin C. In addition, two cases ofclassical HGPS were identified with segmental UPD of chromosome 1q fromfibroblast DNA do not show the mutation, which may be indicative of a(in vivo or in vitro) somatic rescue event.

The results described herein can be generalized to the aging process andrelated conditions and diseases, beyond progeroid diseases. This isbecause HGPS is in many respects closely connected to normal agingprocesses. HGPS continues to be recognized as a useful model of aging(Fossel, Human aging and progeria. J Pediatr Endocrinol Metab. 13 Suppl6:1477-1481, 2000). For instance, the connection to atherosclerosis isvery strong, especially of the coronary arteries. In addition, alopeciain HGPS is similar to that seen in subjects with advanced age. Further,the prime cellular feature of HGPS, as described many years ago byHayflick and others (Hayflick, The cell biology of human aging. N Engl JMed 295:1302-1308, 1976) is early cellular senescence. The limitednumber of cell divisions in HGPS fibroblasts is similar to what is seenin fibroblasts derived from elderly individuals. That was furtherexplored recently by research showing similarities in the geneexpression patterns of HGPS fibroblasts and those derived from elderlypersons, distinguishing them from fibroblasts derived from youngerpersons (Ly et al., Science 287: 2486-2492, 2000).

Specific Identified Mutations

The more common change identified (referred to herein as Mutation 1) isat nucleotide position 4277 in GI 292250 (accession number L12401),which corresponds to amino acid 608 in accession number P02545; thismutation does not change the amino acid-sequence but rather is predictedto generate a cryptic splice site that leads to an alternative splicingvariant of Lamin A. In Mutation 2 there is a change at nucleotideposition 4275 in GI 292250, which corresponds to amino acid 608; thismutation changes a glycine to a serine in Lamin A, and is predicted togenerate the same cryptic splice site as mutation 1. Hence both Mutation1 and Mutation 2 generate the same mutant Lamin A protein. The twomutations both occur in the same codon, which encodes amino acid 608.

The discovery that rare variants in the sequence of LMNA causes HGPSalso enables a variety of diagnostic, prognostic, and therapeuticmethods that are further embodiments. The new appreciation of the roleof Lamin A in HGPS and more generally aging illnesses andarteriosclerosis/atherosclerosis enables detection of predisposition tothese conditions in a subject. This disclosure also enables earlydetection of subjects at high risk of these conditions, and providesopportunities for prevention and/or early treatment.

Since it is predicted that Mutations 1 and 2 will produce a protein thatis 50 amino acids shorter than the wild type Lamin A, a convenientdiagnostic method to identify HGPS is to perform a Western blot and lookfor the abnormal (shorter) band.

In addition, the deletion of the last half of exon 11 (as is predictedto occur with mutations 1 and 2) removes a cleavage site that isnormally necessary for processing of Lamin A. The CaaX box at theC-terminus of Lamin A, which is still present in the mutant forms,allows anchoring of the protein in the membrane—but then this anchoringmechanism is normally removed by the processing cleavage. The Lamin Amutant protein described herein is predicted not to be cleaved, and thusmay be trapped in this membrane location. Since Lamin A is part of alarge multiprotein complex, its mislocalization may well pull otherbystander proteins into the same improper location. It is possible thatthis will lead to structural abnormalities of the nucleus that could bediagnostic for HGPS, and which could be visualized by light microscopy,immunohistochemistry, immunofluorescence, confocal microscopy, orelectron microscopy.

Not meaning to be limited to a single mechanism, it is currentlybelieved that mutations in LMNA that cause HGPS will always be dominant.

It is now believed that the uniparental isodisomy seen in some HGPSpatients, including ones described herein, was by a remarkable andrather unprecedented mechanism. It is believed, for instance, that atthe time of conception individual C8803 had the common G608G mutationdescribed herein. But, as shown by decades of work on skin fibroblastsfrom subjects with HGPS, cells from individuals with this disease growless well than normal ones. We postulate that, either in vivo in thepatient, or in vitro in the cell culture, a rare mitotic crossing overevent occurred, leading to a cell that had lost the long arm ofchromosome 1 that contained the G608G mutation, and instead duplicatedthe normal arm of chromosome 1. That rare event would have essentially“cured” the cell of HGPS, and those cells would then grow better thantheir neighbors. Ultimately, in the cell culture that was studied, noneof the original mutant cells remained, only the rescued cells. Thisexplains why the two patients with UPD, and the one with a deletion(which may also have been a “somatic rescue” event) are the only onesthat do not show a mutation in Table 2. Based on this explanation, it isbelieved that an agent that promotes mitotic crossing over may bebeneficial in treating HGPS, if given early enough. Essentially such adrug would inspire self-healing on a cell-by-cell basis.

The following examples are provided to illustrate certain particularfeatures and/or embodiments. These examples should not be construed tolimit the invention to the particular features or embodiments described.

EXAMPLES Example 1 Identification of LMNA as Implicated in HGPS

This example provides evidence of rare sequence variants in LMNA thatare linked to and causative for Hutchinson-Gilford Progeria Syndrome(HGPS, OMIM #176670), based on molecular genetic analysis of patientswith this disorder.

HGPS is an extremely rare progeroid syndrome. Death occurs on average atage 16, usually from cardiovascular disease. The inheritance pattern ofHGPS is not known. The presence of very few reported affected sibpairsand a modest paternal age effect, together with very few cases of knownconsanguinity, has led some to favor a sporadic dominant mechanism.However, a previous report of a consanguineous family with four affectedsiblings favored autosomal recessive inheritance.

This example demonstrates that de novo mutations in lamin A are thecause of this disorder. Initially the HGPS gene was localized tochromosome 1q by observing two cases of uniparental isodisomy of 1q, andone case with a six megabase (6 Mb) interstitial deletion of allpaternal alleles. Lamin A (LMNA) maps within this interval and emergedas an attractive candidate gene, particularly in view of its role in anumber of other potentially related heritable conditions. SequencingLMNA in 20 classic cases of HGPS revealed that 18 of them harboredexactly the same single base substitution, G608G(GGC>GGT), within exon11 of this gene. The mutation was not found in the parents of theaffected children, indicating that in each case it arose de novo. Oneadditional case was identified with a different substitution within thesame codon [G608S(GGC>AGC)]. Both of these mutations were shown toresult in activation of a cryptic splice site within exon 11, resultingin production of a transcript that deletes 50 amino acids near theC-terminus. Western blotting confirmed the presence of an abnormalprotein product, and immunofluorescence of HGPS fibroblasts withantibodies directed against lamin A revealed that many cells showvisible abnormalities of the nuclear membrane. Without intending to belimited to a single possible explanation, it is currently believed thatthe abnormal lamin A protein acts as a dominant negative, resulting innuclear membrane instability that may be particularly critical intissues subjected to mechanical shearing. The discovery of the molecularbasis of this model of premature aging will shed light on the generalphenomenon of human aging.

Methods and Materials Subjects and DNA/RNA Preparation

This study was approved through the NIH Human Subjects review process.Primary dermal fibroblast cell cultures and EBV transformedlymphoblastoid cell lines from individuals diagnosed as classical HGPSand their first degree relatives (when available), were obtained fromthe Aging Repository of the Coriell Cell Repository (CCR), Camden, N.J.,and the Progeria Research Foundation Cell and Tissue Bank, Peabody,Mass. DNA was prepared using the Puregene DNA isolation kit (GentraSystems, Minneapolis, Minn.). The genome scan for homozygosity includedsamples derived from 12 classical HGPS patients (samples AG01972,AG03259, AG03344, AG03506, AG06297, AG06917, AG10578, AG10579, AG10587,AG10801, AG11498, and AG11513) and 16 unaffected first degree relatives(samples AG03258, AG03260, AG03262, AG03263, AG03343, AG03342, AG03345,AG03346, AG03504, AG03505, AG03507, AG03508, AG06298, AG06299, AG10585,AG10588). Additional samples used in this study were samples fromclassical HGPS (samples AG10677, HGADFN001, HGADFN003, HGALBV009,HGALBV011, HGALBV057, HGADFN005, HGADFN008, HGADFN014, HGALBV071, C8803[also known as AG10548 in the CCR]) and samples derived from theirunaffected first degree relatives (samples HGMLBV010, HGFLBV021,HGMLBV023, HGFLBV031, HGMLBV066, HGFLBV067, HGMLBV013, HGFLBV050,HGMLBV058, HGSLBV059, HGMLBV078, HGFLBV079, HGFLBV082, and HGMLBV081).Total RNA was extracted from cells with TRIzol reagent (Invitrogen).

Genotyping

The whole genome scan included 403 highly polymorphic microsatellitemarkers with an average spacing of 9.2 cM and average heterozygosity of˜0.8 (Gillanders et al. manuscript in preparation). Pedigree checkingwas performed using PedCheck (O'Connell & Weeks, Am J Hum Genet63:259-266, 1998) and any identified genotype errors were removed. Wecarried out homozygosity mapping assuming various degrees of inbreedingfor the HGPS cases (Smith, J. R. Stat. Soc. B 15:153-184, 1953).Additional microsatellite repeats on chromosome 1q were identified usingthe Sputnik program (Abajian, 1994; program available on-line from theUniversity of Washington Department of Molecular Biotechnology)(Table 1) and were used to further investigate the UPD cases and thepaternal deletion region in C8803. Microsatellite markers were analyzedusing a 3100 genetic analyzer (PE Biosystems). Genotypes were analyzedusing GeneScan 3.7 and Genotyper 2.5 Software (PE Biosystems).

TABLE 1 Microsatellite markers chromosome 1q21.3-23.1 Forward primerReverse Marker (SEQ ID primer UCSC June CEPH name NO) (SEQ ID NO) Het2002 1347-02 Pdi3 8 33 0.81 151044102 214/220 Ptetra4 9 34 0.43151052373 284/300 Pdi5 10 35 0.17 151065623 209/209 Pdi9 11 36 0.56151100876 240/240 Pdi10 12 37 0.55 151113665 277/281 Ptetra11 13 38 0.53151124124 328/340 Pdi12 14 39 0.56 151124433 178/182 Ptetra13 15 40 0.74151052373 336/380 Ptetra16 16 41 0.86 151229282 182/186 Ptri25 17 420.53 151484881 167/167 Pdi36 18 43 0.73 151564908 187/187 Pdi74 19 440.76 152144879 259/275 Pdi119 20 45 0.6 152774348 176/176 Dtri22 21 460.39 156340181 177/177 Ddi24 22 47 0.84 156372998 260/266 Ddi30 23 480.75 156475805 239/239 Dtetra32 24 49 0.72 156485165 115/115 Dtetra39 2550 0.35 156607074 314/314 Dtetra43 26 51 0.22 156669559 286/286 Dtetra4627 52 0.74 156708500 236/236 Ddi47 28 53 0.49 156735453 232/238 Ddi51 2954 0.24 156782785 300/300 Ddi59 30 55 0.49 156890236 131/135 Ddi60 31 560.62 156892710 158/162 Ddi62 32 57 0.6 156905327 246/256

FISH

Single-color and two-color FISH was performed on metaphases from sampleC8803 following previously published procedures (Casper et al., Cell111:779-789, 2002), using a subset of BACs in the region of the paternaldeletion. BACs used as probes for the FISH analysis were RP1-140J1,RP1-148L21, RP1-178F15, RP11-137P24, RP11-66D17, RP11-110J1, RP11-91G5,RP11-120D12, RP11-101J8, RP11-81N17, RP11-144L1, RP11-317F9,RP11-452022, and RP11-137M19.

Mutation Analysis of LMNA

Direct sequencing of LMNA was performed primarily using previouslydescribed primer sequences for the LMNA exons 1-12 (De Sandre-Giovannoliet al., Am. J. Hum. Genet. 70:726-736, 2002). Additional primers forLMNA were designed for three exons: exon 4 (5′-agcactcagctcccaggtta-3′and 5′-ctgatccccagaaggcatag-3′; SEQ ID NOs: 58 and 59), exon 6(5′-gtccctccttccccatactt-3′ and 5′-ccaagtgggggtctagtcaa-3′; SEQ ID NOs:60 and 61), and exon 7 (5′-aggtgctggcagtgtcctct-3′ and5′-ctctgagggcaaggatgttc-3′; SEQ ID NOs: 62 and 63). All primers used forsequencing were synthesized with M13 forward and reverse tags. The PCRproducts were cleaned up with the QiaQuick PCR purification kits usingthe BioRobot 8000 Automated Nucleic Acid Purification and LiquidHandling robot (Qiagen). Sequencing reactions were performed at quarterstrength reaction volumes with the Big Dye Terminator chemistry kit(Applied Biosystems), and electrophoresed on an ABI 3700 DNA Analyzer(Applied Biosystems). Multiple sequence alignment was performed withSequencher (Genecodes Inc., Ann Arbor, Mich.). Attempts were made tosequence all PCR products in both directions, but approximately 13% ofexons failed to yield readable sequence.

RT-PCR on Exon 11 For all RNA samples, 20 μg of total RNA was treatedwith RQ1 RNase-Free DNase according to manufacturer's recommendations(Promega, USA). 800 ng of DNase-treated total RNA was used for firststrand cDNA synthesis with random hexamers (Superscript™ Invitrogen).Control samples without reverse transcriptase were processed at the sametime for each sample. PCR primers for the lamin A/C gene were designedin exon 7/8 and exon 12. Primer sequences were5′-gcaacaagtccaatgaggacca-3′ and 5′-gtcccagattacatgatgc-3′ (SEQ ID NOs:64 and 65). PCR fragments were gel-purified or cloned (TOPO TA-cloningkit, Invitrogen) and sequenced. PCR with GAPDH-specific primers wereperformed on all samples as control.

Western Analysis

Whole cells (1×10⁶) were harvested and washed 2× in PBS. The pelletswere resuspended in RIPA buffer (50 mM Hepes pH 7, 0.1% SDS, 1% TritonX-100, 1 mM EDTA, 1% Deoxycholic acid, and 150 mM NaCl), including acocktail of proteinase inhibitors (Roche). Protein concentrations wereassayed with the BCA protein assay kit (Pierce, Perbio, Rockford, USA)and analyzed on a spectrophotometer. Twenty μg of protein was mixed withSDS protein-loading buffer, boiled for two minutes and placed on ice,and then electrophoresed on an 8% Tris-Glycine mini gel (Invitrogen).Blots were transferred to nitrocellulose and incubated with primarymonoclonal antibody against lamin A/C (JOL2, Chemicon International,USA) at 4° C., for 12 hours. Following room temperature washes in TBST,FITC-conjugated secondary antibody (Jackson ImmunoResearch laboratories,USA) was added and incubated for 45 minutes at room temperature. Thefilters were exposed using the ECL+ plus Western blotting detectionsystem (Amersham Biosciences).

Immunofluorescence

Fibroblasts were cultivated on cover slips in 24-well dishes at 37° C.in the presence of 5% CO₂. Cells at 50-70% confluence were fixed (3.2%PFA), permeabilized (1% NP40), and blocked (0.1% Brij58, and 5% goat ordonkey serum corresponding to 2^(nd) antibody origin). Lamin A/C(monoclonal antibodies JOL2, Chemicon International, USA, and cloneXB10, CRP Inc., USA) and mitochondria (HMS-0100, Immunovision Inc.,Springdale, Ala., USA) were labeled for immunofluorescence. For stainingof nuclear DNA, 4,6-diamidine-2-phenylindole dihydrochloride (DAPI) wasadded during the incubation with the 2^(nd) antibody at 1 μg/ml.Analysis was done by confocal microscopy using a BioRad 1024 and LeicaSP2 system, and visualized as green (lamin A/C), red (mitochondria), andblue (DAPI) color channels using CoolLocalizer imaging software(Cytolight, Stockholm, Sweden).

Cell Cycle and Apoptosis

Cells were harvested and washed in PBS, one day following theimmunofluorescence experiments. Duplicate experiments were performed oneach cell culture. A total of 5×10⁵ cells were resuspended in 0.5 ml ofNuCycl Propidium Iodide (NuCycl™ PI kit, Exalpha Corp., Boston, Mass.)and processed as recommended by the manufacturer. The total DNA contentwas measured by DNA flow cytometry. Cells were also assayed forviability using Annexin V-FITC and Propidium Iodide according tostandardized procedures (BD Biosciences).

Results Initial Mapping of the HGPS Gene to Chromosome 1q

A genome-wide scan searching for evidence of homozygosity was conducted,a powerful tool to identify loci for rare recessive disorders (Smith, J.R. Stat. Soc. B 15:153-184, 1953; Lander & Botstein, Science236:1567-1570, 1987). Assuming that in a rare recessive disorder, manycases will be homozygous for a particular mutation, one would expect tosee statistical evidence for homozygosity of closely linked markers inthe region of the gene. A whole genome scan including 403 polymorphicmicrosatellite markers with an average spacing of 9.2 cM was performedon 12 DNA samples derived from individuals considered to representclassic HGPS. While no evidence of homozygosity was identified in theoverall sample set, two HGPS samples were found to have uniparentalisodisomy (UPD) of chromosome 1q (FIG. 1A). For one of these cases, DNAsamples from the mother and the brother were available. In that case, itwas possible to determine that the isodisomic segment is of maternalorigin, and that there is biparental inheritance of the short arm ofchromosome 1. Spectral karyotyping (SKY) and G-banding of one of the twoUPD cases showed a normal karyotype.

An earlier report (Brown, Am. J. Clin. Nutr. 55:1222S-1224S, 1992)described an abnormal karyotype in a monozygotic twin with HGPS. Thatreport described a mosaic cell population in which 70% of the cellscontained a balanced inverted insertion [46 XY, inv ins(1;1)(q32;q44q23)], whereas the rest of the cells had an apparentlynormal karyotype. A fibroblast culture was obtained from the sameindividual (sample ID C8803), as well as his parents. Karyotypingconfirmed the original result, though only a small minority of themetaphases now showed the rearrangement of chromosome 1 (FIG. 1B).Surprisingly, genotyping of microsatellite markers identified a roughly6 megabase interval where all paternal markers were completely missing(FIG. 1C). It was confirmed that this deletion was also present in thecells that had an apparently normal karyotype, using fluorescent in situhybridization (FISH) with BACs that map throughout this interval (FIG.1D). Putting all of this information together with genotypes from atotal of 44 additional microsatellite markers, it was determined thatthe HGPS gene must lie in an interval of 4.82 Mb on proximal chromosome1q (FIG. 1E).

Identification of the HGPS Gene

The candidate interval contains roughly 80 known genes. Attention wasdrawn to one of them, the LMNA gene that encodes two protein products(Lamin A and Lamin C), representing major constituents of the innernuclear membrane lamina. Mutations in LMNA have previously been found tobe the cause of six different recessive and dominant disorders,including Emery-Dreifuss muscular dystrophy type 2, a form of dilatedcardiomyopathy, the Dunnigan type of familial partial lipodystrophy,limb girdle muscular dystrophy type 1B, Charcot-Marie-Tooth disordertype 2B 1, and mandibuloacral dysplasia (for a review of laminopathies,see Burke & Stewart, Nature Rev. 3:575-585, 2002).

The LMNA gene contains 12 exons and covers ˜25 kb of genomic DNA. LaminA is coded by exons 1-12 and lamin C by exons 1-10 (FIG. 5). A splicesite within exon 10, located just upstream of the stop codon for laminC, splices together with exons 11 and 12 to code for lamin A (McKeon etal., Nature 319:463-468, 1986; Fisher et al., Proc. Nat. Acad. Sci.83:6450-6454, 1986; Lin & Worman, J. Biol. Chem. 268:16321-16326, 1993).

PCR amplification of all of the exons of the LMNA gene (includingexon-intron boundaries), followed by direct sequencing, was carried outin 23 samples from patients with classical HGPS. In 18 of these samples,a heterozygous base substitution [G608G(GGC>GGT)] within exon 11 of theLMNA gene was identified (FIG. 2A). In HGPS sample AG10801 a differentheterozygous base substitution was identified within the same codon[G608S(GGC>AGC)] (FIG. 2A). In HGPS sample AG10677, a heterozygous basesubstitution was identified within exon 2 [E145K (GAG>AAG)].

In the eight cases where DNA from both parents was available, the G608Gmutation was absent in the parents, confirming that these are de novomutations. Similarly, the G608S and E145K mutations were not found inparents of AG10801 or AG10677, respectively. Thus, of the 23 classicHGPS cases studied, there were only three in which no LMNA mutationswere found (Table 2): the two UPD cases (AG10578 and HGADFN005), and thesample with the 6 Mb paternal deletion (C8803).

TABLE 2 Codon Classical HGPS 608 seq Mutation Comment Mother FatherSibling(s) AG01972 GGC/T G608G NA NA NA AG06297 GGC/T G608G NA NA NAAG10801 A/GGC G608S NA NA NA AG11498 GGC/T G608G NA NA NA AG11513 GGC/TG608G NA NA NA AG03506 GGC/T G608G Normal Normal Normal AG03344 GGC/TG608G Normal Normal Normal AG03259 GGC/T G608G Normal Normal NormalAG06917 GGC/T G608G Normal Normal NA AG10578 GGC UPD Normal NA NormalAG10579 GGC/T G608G NA NA NA AG10587 GGC/T G608G Normal NA ND HGADFN001GGC/T G608G NA NA NA HGADFN003 GGC/T G608G NA NA NA HGADFN004 GGC NA NANA AG10677* GGC NA NA NA HGALBV009 GGC/T G608G Normal Normal NAHGALBV011 GGC/T G608G Normal Normal NA HGALBV057 GGC/T G608G NormalNormal NA HGADFN005 GGC UPD NA NA NA HGADFN008 GGC/T G608G NA NA NAHGADFN014 GGC/T G608G NA NA NA HGALBV071 GGC/T G608G NA NA NAAG10548/C8803 GGC Deletion Normal Normal NA NA, not available; seq,nucleotide sequence; *normal at codon 145. Additional sequence variants,presumed to be polymorphisms, were identified in exon 3 [L240L (CTG >CTA)], intron 4 (IVS4 + 61C > T), exon 5 [A287A (GCT > GCC)], exon 7[D446D (GAT > GAC)], intron 8 (IVS8-41C > T), and exon 10 [H566H (CAC >CAT)]. The variants in exons 5, 7, and 10 have been previously reported(Genschel & Schmidt, Hum. Mutat. 16: 451-459, 2000; Speckman et al., Am.J. Hum. Genet. 66: 1192-1198, 2000; Speckman et al., (errata) Am. J.Hum. Genet. 67: 775, 2000).

Mechanism of Disease Causation

The most common mutation, G608G(GGC>GGT), is a silent substitution. Thesecond mutation in that same codon, G608S(GGC>AGC), results in aconservative substitution of serine for glycine. How is it possible thatthese bland-appearing de novo mutations could cause HGPS? Inspection ofthe normal sequence surrounding codon 608 reveals that both of theobserved HGPS mutations improve the match to a consensus splice donor(FIG. 2B), suggesting that they might activate a cryptic splice site.

To confirm this, RT-PCR was performed using a forward primer spanningthe junction of exons 7 and 8, and a reverse primer in exon 12. In RNAfrom unaffected individuals, the expected product appears (FIG. 2C). InRNA samples from cell lines harboring HGPS mutations, an additionalsmaller RT-PCR product appears. Sequence of these fragments shows that150 nucleotides within exon 11 are missing. As the reading frame ismaintained, this abnormal transcript would be expected to code for aprotein with an internal deletion of 50 amino acids near the C-terminusof lamin A. Lamin C would be unaffected.

Cloning and sequencing of the normal full-length fragment obtained fromRT-PCR on RNA extracted from primary fibroblasts containing the morecommon codon 608 mutation revealed that 7/23 clones carry the mutantsequence. Thus, activation of the cryptic splice site within exon 11 isnot complete.

In order to determine if the mutant mRNA is actually translated intoprotein, a Western blot was performed, using a monoclonal antibodyagainst lamin A/C (FIG. 3). In addition to the normal bands for Lamin Aand Lamin C, an additional band is present in four of the lanescorresponding to samples from classical HGPS cases, but not in theirparents. The abnormal band is not visible in the lane that contains theprotein sample from HGPS patient AG11498 [which carries G608G(GGC>GGT)],but this is likely due to the very small amount of lamin A beingexpressed in this particular fibroblast culture.

Immunofluorescence studies with two different monoclonal antibodiesagainst lamin A/C (FIG. 4) were performed on primary fibroblasts fromtwo unaffected parents (AG06299 and AG06298) and two classical HGPScases (AG11498 and AG06917), where the common mutation has beenidentified (Table 2). In 48% of the cells from the samples withclassical HGPS, an irregular shape of the nuclear envelope was noted(FIG. 4E-4H). Cells from the unaffected controls (FIG. 4A-4D) showedsignificantly fewer cells of this phenotype (<6%).

To be certain that this result was not an artifact of secondarydifferences in the status of the HGPS and control fibroblast cultures,cells originating from the same flasks as the cells used for theimmunofluorescence studies were monitored for differences in cell cycle(by fluorescent-activated cell analysis) and degree of apoptosis withpropidium iodide and Annexin. No significant differences between thecells derived from the classical HGPS patients and the unaffectedparents were noted.

Discussion

Based on the results reported herein, HGPS can now be added to theremarkably long list of human genetic disorders shown to be due tomutations in the LMNA gene. This list includes both dominant andrecessive conditions. A review of the available data ongenotype-phenotype correlations (Genschel & Schmidt, Hum. Mutat.16:451-459, 2000) suggests that the human phenotype of complete loss offunction of LMNA is Emery-Dreifuss muscular dystrophy, and otherphenotypes arise from missense changes in various domains of the Lamin Aand Lamin C proteins. The HGPS mutation is unusual in two major ways: 1)it involves a large internal deletion of the coding region; 2) itaffects lamin A exclusively.

The de novo recurrence of the same exact point mutation in 18 out of 20cases of classic HGPS is a surprising finding, but is not withoutprecedent. The common HGPS mutation is a C to T in the context of a CpGdinucleotide, which is well known to represent the most mutable base inthe vertebrate genome, since a methylated C readily can be deaminated toT and miscopied. A very similar phenomenon occurs in achondroplasia(Shiang et al., Cell 78:335-342, 1994; Rousseau et al., Nature371:252-254, 1994), where nearly all sporadic cases are due to CpG toTpG mutations in the FGFR3 gene, resulting in an apparent gain offunction mutation (G380R).

Data presented here indicate that the HGPS mutations in codon 608 ofLMNA lead to abnormal splicing and a protein product that lacks 50 aminoacids near the C-terminus. Extensive prior study of the biochemicalfunction of lamin A suggests a possible mechanism for disease causation.Lamin A is normally synthesized as a precursor molecule (prelamin A). Atthe C-terminus is a CAAX (SEQ ID NO: 66)-box motif that is subject tofarnesylation. Following that, an internal proteolytic cleavage occurs,removing the last 18 coding amino acids (Lutz et al., Proc. Natl. Acad.Sci. USA 89:3000-3004, 1992; Sinensky et al., J. Cell Sci. 107:61-67,1994; Hennekes & Nigg, J. Cell Sci 107:1019-1029, 1994), to generatemature lamin A. It is predicted that the HGPS mutations and consequentabnormal splicing would produce a prelamin A that still retains the CAAX(SEQ ID NO: 66) box, but is missing the site for endoproteolyticcleavage.

There is also evidence that cell cycle dependent phosphorylation oflamin A is important for its normal function, and at least one site forphosphorylation (Ser625) is deleted in the abnormal HGPS protein (Eggertet al., Eur. J. Biochem. 213:659-671, 1993). As lamin A forms amultiprotein complex within the inner nuclear membrane, thisincompletely processed prelamin A may act as a dominant negative.Indeed, the immunofluorescence images (FIG. 4) document majorconsequences of the HGPS mutations for nuclear membrane stability.Following repeated cell divisions, it can be envisioned that cellsexpressing the abnormal form of prelamin A may ultimately becomenonviable and undergo apoptosis. This might be particularly prominent incells that are exposed to mechanical shear forces, such as in thecardiovascular and musculoskeletal systems. The delay in appearance ofthe HGPS phenotype, which generally only becomes apparent at around oneyear of age, may be due to the developmental timing of expression oflamin A/C, which is generally not expressed in early embryogenesis or inless differentiated cells (Rober et al., Dev. 105:365-378, 1989).

Interestingly, defective prelamin A processing recently has beenidentified in a mouse knockout of the Zmpste24 metalloproteinase (Pendaset al., Nature Genet. 31:94-99, 2002; Bergo et al., Proc. Natl. Acad.Sci. USA 99:13049-13054, 2002). Zmpste24 is believed to be involved inproteolytic processing of prelamin A, and may represent the actualendoprotease. The homozygote knockout of Zmpste24 presents with aphenotype resembling clinical features observed in HGPS patients,including growth retardation, premature death (20 weeks) from cardiacdysfunction, and alopecia. However, additional features such aspronounced osteoporosis are also present (Bergo et al., Proc. Natl.Acad. Sci. USA 99:13049-13054, 2002). Immunofluorescence experiments oncells from these animals show considerable similarity to what isobserved in cells from HGPS patients (FIG. 4). A mouse knockout of theLMNA gene has also been previously reported (Sullivan et al., J. CellBiol. 147:913-920, 1999). Severe postnatal growth retardation andmuscular dystrophy are observed, and immunofluorescence of nuclei showselongated and irregular cells with herniation of nuclei.

While the major cause of HGPS appears to be the creation of an abnormalsplice donor in exon 11, the finding of a de novo point mutation in exon2 in a single patient (AG10677) is of interest. In retrospect, thispatient (Smith et al., Am. J. Neuroradiol. 14:441-443, 1993) hadsomewhat atypical clinical features (including persistence of coarsehair over the head, ample subcutaneous tissue over the arms and legs,and severe strokes beginning at age 4) that may subtly distinguish thisphenotype from classical HGPS.

No LMNA mutations were identified in three of the 23 classical HGPSsamples (Table 2). These are the very samples that assisted mapping ofthe HGPS gene to chromosome 1q. The two UPD cases present an interestingdilemma—if the LMNA gene sequence is normal in both cases, why do theyhave HGPS? The possibility of imprinting must be considered—but priorcases of both paternal and maternal complete isodisomy of chromosome 1do not support the presence of any imprinted loci on this chromosome(Pulkkinen et al., Am. J. Hum. Genet. 61:611-619, 1997; Gelb et al., Am.J. Hum. Genet. 62:848-854, 1998). In the case where DNA samples wereavailable from the mother and sibling (FIG. 1A), we conclude that thisphenomenon resulted in a chromosome that has partly paternal and partlymaternal alleles. This must have arisen by some kind ofpost-fertilization event, most likely a mitotic crossover betweenhomologs. Such events may occur rarely in normal development, but wouldnormally not be expected to lead to clonal expansion.

It is currently postulated that these cases actually represent “somaticrescue” events of the premature senescence phenotype of HGPS. Under thishypothesis, the individuals from whom these fibroblasts were derivedoriginally harbored typical codon 608 HGPS mutations in LMNA. Perhaps asan in vivo event, or perhaps as an in vitro event in the fibroblastculture, a mitotic crossover occurred, generating a cell with segmentalUPD that had duplicated the wild type allele of LMNA and lost the HGPSmutation. Such a cell would likely then have a growth advantage over itsneighbors. This did not happen very early in embryogenesis in the twoUPD cases, or they would not have been clinically affected. Proof ofthis hypothesis would require access to multiple tissues of the deceasedUPD patients, which unfortunately are not available.

No mutation in the LMNA gene was identified in the patient with the 6 Mbdeletion (FIG. 1C). It is believed that this might also be due to asomatic rescue event—specifically, it is hypothesized that this patientwas originally heterozygous for a codon 608 LMNA mutation, but in thisinstance the “rescue” involved an internal deletion of 6 Mb containingthe mutant allele, associated with a more complex mosaic rearrangementof chromosome 1. It is interesting that this patient (and hismonozygotic twin) showed particularly severe disease, with contracturespresent at birth, which might be a consequence of the complete loss ofone allele of LMNA in the “rescued” tissues.

Recently, Delgado-Luengo et al. reported on a case of classic HGPS inwhich an apparent interstitial deletion of chromosome 1q23 was seen (Am.J. Med. Genet. 113:298-301, 2002). Cells and DNA was obtained from thispatient and surprisingly the typical heterozygous G608G mutation ispresent. Furthermore, it has not been possible to confirm the presenceof an interstitial deletion by high resolution chromosome banding or byFISH with BACs spanning the 1q23-1q24 region. This may be anotherexample of somatic rescue, involving an interstitial deletion in theclone of cells analyzed in the original report, but not present in othersamples from the same patient.

The clinical implications of the discovery of the mutational basis ofHGPS are twofold. First, since most cases of HGPS appear to have a denovo mutation in the same codon, molecular diagnostics are immediatelyfeasible. This will be particularly useful in making the diagnosis in ayoung child before the full clinical phenotype has appeared. Moleculardiagnostic methods may also provide reassurance in the prenatal arena,where the possibility of parental somatic mosaicism and recurrence ofdisease in future pregnancies can now be addressed. Second, thedelineation of the molecular mechanism provides possible therapeuticapproaches. For example, farnesylation inhibitors (such as the statinsor farnesyl transferase inhibitors) might reduce the amount of mutantprelamin A. High throughput screens to identify small molecules thatreverse the nuclear membrane abnormalities can also now be contemplated.

In addition, the discovery of the molecular basis of HGPS suggests apossible role for LMNA in aspects of the normal aging process. It willbe important to look for common variants in this gene that might showassociation with exceptional longevity, and perhaps also to explorewhether somatic mutations in LMNA, accumulated over a lifetime, playsome role in senescence.

Example 2 Other LMNA Polymorphisms and/or Mutations

With the provision herein of the correlation between LMNA gene variantsand HGPS, the isolation and identification of additional LMNA variants,including variants that lead to progeroid syndromes, is enabled andmotivated. Any conventional method for the identification of geneticpolymorphisms in a population can be used to identify such additionalpolymorphisms.

For instance, selective breeding studies in animals are performed toisolate different variants of LMNA. Alternatively, existing populations(e.g., mouse or human populations) are assessed for progeria and/orage-related or premature aging conditions, and individuals within thepopulation (particularly those with symptoms of progeria or otherpremature aging conditions) are genotyped as relates to an LMNAsequence. These LMNA sequences are then compared to a reference LMNAsequence, such as the normal allele shown herein, to determine thepresence of one or more variant nucleotide positions. Once variantnucleotides are identified, statistical analysis of the population isused to determine whether these variants are correlated with progeriaand/or another aging-related condition, such as arteriosclerosis andarthrosclerosis.

Alternatively, it is expected that a variant in LMNA that has an effecton normal aging (but is not so severe as to result in a progeroidcondition) will be relatively common. In order to study such variants,data can be collected on as many SNPs in LMNA (upstream, downstream,exons, introns) as possible—for instance by surveying public databases,resequencing the gene (e.g., in a number of extremely aged individualsand a number of individuals with average longevity) and analyzing theresultant sequences. How the identified SNPs correlate with theirneighbors would be noted, in order to construct “haplotypes.” Genotypingof the SNPs that define the haplotypes would then be carried out, todetermine whether there are any haplotypes that are overrepresented orunderrepresented in individuals of exceptional age.

Also identified are additional mutations in LMNA that are believed tocontribute to or be linked to progeroid conditions. These includeheterozygous R644C (identified in sample ID AG00989 (atypical progeria);clinical description: diagnosed with atypical progeria and anunspecified type of cachectic dwarfism); heterozygous E145K (identifiedin sample ID AG10677 (atypical progeria); clinical description: Clinicalsigns of progeria, including short stature, failure to thrive, partialalopecia of the scalp, dry irregularly hyperpigmented skin, pointednose, protruding eyes, micrognathia, and high forehead); heterozygousR471C (exon 8) and R527C (exon 9) (identified in sample ID AG07091(atypical progeria); clinical description: Progeria); and heterozygousA269V (identified in sample ID AG01178 (atypical progeria); clinicaldescription: Progeria).

Example 3 Clinical Uses of LMNA Variants

To perform a diagnostic test for the presence or absence of apolymorphism or mutation in an LMNA sequence of an individual, asuitable genomic DNA-containing sample from a subject is obtained andthe DNA extracted using conventional techniques. For instance in someembodiments a blood sample, a buccal swab, a hair follicle preparation,or a nasal aspirate is used as a source of cells to provide the DNAsample. The extracted DNA is then subjected to amplification, forexample according to standard procedures. The allele of the singlebase-pair polymorphism is determined by conventional methods includingmanual and automated fluorescent DNA sequencing, primer extensionmethods (Nikiforov, et al., Nucl Acids Res. 22:4167-4175, 1994),oligonucleotide ligation assay (OLA) (Nickerson et al., Proc. Natl.Acad. Sci. USA 87:8923-8927, 1990), allele-specific PCR methods (Rust etal., Nucl. Acids Res. 6:3623-3629, 1993), RNase mismatch cleavage,single strand conformation polymorphism (SSCP), denaturing gradient gelelectrophoresis (DGGE), Taq-Man, oligonucleotide hybridization,MALDI-TOF mass spectrometry, and the like. Also, see the following U.S.Patents for descriptions of methods or applications of polymorphismanalysis to disease prediction and/or diagnosis: U.S. Pat. No. 4,666,828(RFLP for Huntington's); U.S. Pat. No. 4,801,531 (prediction ofatherosclerosis); U.S. Pat. No. 5,110,920 (HLA typing); U.S. Pat. No.5,268,267 (prediction of small cell carcinoma); and U.S. Pat. No.5,387,506 (prediction of dysautonomia).

Examples of rare variants associated with progeria, particularly HGPS,and/or an increased likelihood of an age-related condition are themutations referred to herein as Mutation 1 and Mutation 2. The absenceof these or similar mutations in LMNA indicates a relative lowlikelihood of carrying or having progeria and a relatively decreasedlikelihood of having other premature age-related conditions or progeroidconditions (e.g., atypical progeria, cachectic dwarfism). In addition tothese particular polymorphisms, other alleles that may be associatedwith variable predisposition to progeria (e.g., HGPS) can also bedetected, and used in combination with the disclosed LMNA polymorphismsto predict the probability that a subject will tend to develop progeriaor be likely to develop another age-related condition or disease, or bea genetic carrier of such a likelihood.

For instance, it is believed that mutations in the site for the laststep in the post translational processing of prelamin A (i.e., mutationsin the RSYLLG motif), may also lead to disease symptoms similar to thoseseen in progeria subjects, for instance those with a codon 608 mutationas discussed herein. This region is deleted in these mutant alleles, dueto the aberrant splicing of exon 11.

The markers of the present disclosure can be utilized for the detectionof, and differentiation of, individuals who are heterozygous for theMutation 1 and/or Mutation 2 variants; it is believed to be extremelyunlikely that homozygous individuals would be identified, since themutations that have been identified are new and occur sporadically. Thevalue of identifying individuals who carry a progeria allele of LMNA(e.g., individuals who are heterozygous for an allele that contains aprogeria-linked LMNA polymorphism, such as the G to A base substitutionat nucleotide position 1822, or the C to T base substitution at position1824) is that this allows a precise molecular diagnosis of a conditionthat is often difficult to be certain of in a young child. Identifyingone of these mutations, and showing that it is not present in theparents (as has been the case in every instance so far studied) alsoallows accurate genetic counseling about a very low recurrence risk,which will be very important for parents who are wondering about futurechild-bearing. Furthermore, these individuals can then furtherinvestigate their health situation regarding premature aging disease.

Example 4 Polymorphism/Mutation Gene Probes and Markers

Sequences surrounding and overlapping single base-pair polymorphisms inthe LMNA gene can be useful for a number of gene mapping, targeting, anddetection procedures. For example, genetic probes can be readilyprepared for hybridization and detection of Mutation 1 or Mutation 2polymorphisms. As will be appreciated, probe sequences may be greaterthan about 12 or more oligonucleotides in length and possess sufficientcomplementarity to distinguish between the alleles. Similarly, sequencessurrounding and overlapping either of the specifically disclosed singlebase-pair polymorphisms (or other polymorphisms found in accordance withthe present teachings), or sequences encompassing both specificallydisclosed polymorphisms, can be utilized in allele specifichybridization procedures. A similar approach can be adopted to detectother LMNA polymorphisms.

Sequence surrounding and overlapping an LMNA polymorphism, or anyportion or subset thereof that allows one to identify the polymorphism,are highly useful. Thus, another embodiment provides a genetic markerpredictive of the Mutation 1 polymorphism of LMNA, comprising a partialsequence of the human genome including at least about 10 contiguousnucleotide residues including “N” in the following nucleotide sequence:ggagcccaggtgggnggacccatctcctctggct (nucleotides 111-141 of SEQ ID NO:4), and sequences complementary therewith, wherein “N” represents C or asingle base-pair polymorphism of the C that is present at N in a humanallele of LMNA. One example polymorphism is a C to T base substitution,but can also include a C to A or C to G base substitution.

Likewise, another specific embodiment is a genetic marker predictive ofa Mutation 2 polymorphism of LMNA, comprising a partial sequence of thehuman genome including at least about 10 contiguous nucleotide residuesin the following nucleotide sequence: ggagcccaggtgngcggacccatctcctctggct(nucleotides 111-141 of SEQ ID NO: 5), and sequences complementarytherewith, wherein “N” represents G or a single base-pair polymorphismof the G that is present at N in a human allele of LMNA. One examplepolymorphism is a G to T base substitution, but can also include a G toA or G to C base substitution.

Example 5 Detecting SNPs/Rare Variants

Variants of the normal LMNA sequence, such as those at nucleotideresidue 1822 (the first position encoding amino acid residue 608) and/ornucleotide residue 1824 (the last position encoding amino acid 608), canbe detected by a variety of techniques. These techniques includeallele-specific oligonucleotide hybridization (ASOH) (Stoneking et al.,Am. J. Hum. Genet. 48:370-382, 1991) which involves hybridization ofprobes to the sequence, stringent washing, and signal detection. Othernew methods include techniques that incorporate more robust scoring ofhybridization. Examples of these procedures include the ligation chainreaction (ASOH plus selective ligation and amplification), as disclosedin Wu and Wallace (Genomics 4:560-569, 1989); mini-sequencing (ASOH plusa single base extension) as discussed in Syvanen (Meth. Mol. Biol.98:291-298, 1998); and the use of DNA chips (miniaturized ASOH withmultiple oligonucleotide arrays) as disclosed in Lipshutz et al.(BioTechniques 19:442-447, 1995). Alternatively, ASOH with single- ordual-labeled probes can be merged with PCR, as in the 5′-exonucleaseassay (Heid et al., Genome Res. 6:986-994, 1996), or with molecularbeacons (as in Tyagi and Kramer, Nat. Biotechnol. 14:303-308, 1996).

Another technique is dynamic allele-specific hybridization (DASH), whichinvolves dynamic heating and coincident monitoring of DNA denaturation,as disclosed by Howell et al. (Nat. Biotech. 17:87-88, 1999). A targetsequence is amplified by PCR in which one primer is biotinylated. Thebiotinylated product strand is bound to a streptavidin-coated microtiterplate well, and the non-biotinylated strand is rinsed away with alkaliwash solution. An oligonucleotide probe, specific for one allele, ishybridized to the target at low temperature. This probe forms a duplexDNA region that interacts with a double strand-specific intercalatingdye. When subsequently excited, the dye emits fluorescence proportionalto the amount of double-stranded DNA (probe-target duplex) present. Thesample is then steadily heated while fluorescence is continuallymonitored. A rapid fall in fluorescence indicates the denaturingtemperature of the probe-target duplex. Using this technique, asingle-base mismatch between the probe and target results in asignificant lowering of melting temperature (T_(m)) that can be readilydetected.

A variety of other techniques can be used to detect the variations inDNA. Merely by way of example, a variety of detection techniques can befound in U.S. Pat. Nos. 4,666,828; 4,801,531; 5,110,920; 5,268,267;5,387,506; 5,691,153; 5,698,339; 5,736,330; 5,834,200; 5,922,542; and5,998,137 for such methods. In specifically contemplated embodiments,variations in sequence are detected using MALDI-TOF massspectrophotometery

Example 6 Detection of LMNA Nucleic Acid Level(s)

Individuals carrying mutations in the LMNA gene, or havingamplifications or heterozygous deletions of the LMNA gene, may bedetected at the DNA or RNA level with the use of a variety oftechniques. The detection of point mutations was discussed above; in thefollowing example, techniques are provided for detecting the level ofLMNA nucleic acid molecules in a sample.

For such diagnostic procedures, a biological sample of the subject (ananimal, such as a mouse or a human), which biological sample containseither DNA or RNA derived from the subject, is assayed for a mutated,amplified or deleted LMNA encoding sequence, such as a genomicamplification of the LMNA gene or an over- or under-abundance of a LMNAmRNA. Suitable biological samples include samples containing genomic DNAor mRNA obtained from subject body cells, such as those present inperipheral blood, urine, saliva, tissue biopsy, surgical specimen,amniocentesis samples and autopsy material. The detection in thebiological sample of a mutant LMNA gene, a mutant LMNA RNA, or anamplified or homozygously or heterozygously deleted LMNA gene, may beperformed by a number of methodologies.

Gene dosage (copy number) can be important in disease states, and caninfluence mRNA and thereby protein level; it is therefore advantageousto determine the number of copies of LMNA nucleic acids in samples oftissue. Probes generated from the encoding sequence of LMNA (LMNA probesor primers) can be used to investigate and measure genomic dosage of theLMNA gene.

Appropriate techniques for measuring gene dosage are known in the art;see for instance, U.S. Pat. No. 5,569,753 (“Cancer Detection Probes”)and Pinkel et al. (Nat. Genet. 20:207-211, 1998) (“High ResolutionAnalysis of DNA Copy Number Variation using Comparative GenomicHybridization to Microarrays”).

Determination of gene copy number in cells of a patient-derived sampleusing other techniques is known in the art. By way of example,interphase FISH analysis of immortalized cell lines can be carried outas previously described (Barlund et al., Genes Chromo. Cancer20:372-376, 1997). The hybridizations can be evaluated using a Zeissfluorescence microscope. By way of example, approximately 20non-overlapping nuclei with intact morphology based on DAPI counterstainare scored to determine the mean number of hybridization signals foreach test and reference probe.

Likewise, FISH can be performed on tissue microarrays, as described inKononen et al., Nat. Med. 4:844-847, 1998. Briefly, consecutive sectionsof the array are deparaffinized, dehydrated in ethanol, denatured at 74°C. for 5 minutes in 70% formamide/2×SSC, and hybridized with test andreference probes. The specimens containing tight clusters of signalsor >3-fold increase in the number of test probe as compared tochromosome 17 centromere in at least 10% of the tumor cells may beconsidered as amplified. Microarrays using various tissues can beconstructed as described in WO9944063 and WO9944062.

Overexpression or under expression of the LMNA gene can also be detectedby measuring the cellular level of LMNA-specific mRNA. mRNA can bemeasured using techniques well known in the art, including for instanceNorthern analysis, RT-PCR and mRNA in situ hybridization. Additionally,since splice variants such as the one identified herein as Mutation 1produce different length mRNAs compared to those produced from normal(wildtype) LMNA, changes can be detected by examining transcripts on aNorthern blot.

Example 7 Expression of Lamin A Polypeptides

The expression and purification of proteins, such as the Lamin Aprotein, can be performed using standard laboratory techniques. Afterexpression, purified Lamin A protein may be used for functionalanalyses, antibody production, diagnostics, and patient therapy.Furthermore, the DNA sequence of the LMNA/Lamin A cDNA can bemanipulated in studies to understand the expression of the gene and thefunction of its product. Mutant forms of the human LMNA gene may beisolated based upon information contained herein, and may be studied inorder to detect alteration in expression patterns in terms of relativequantities, tissue specificity and functional properties of the encodedmutant Lamin A protein. Partial or full-length cDNA sequences, whichencode for the subject protein, may be ligated into bacterial expressionvectors. Methods for expressing large amounts of protein from a clonedgene introduced into Escherichia coli (E. coli) may be utilized for thepurification, localization and functional analysis of proteins. Forexample, fusion proteins consisting of amino terminal peptides encodedby a portion of the E. coli lacZ or trpE gene linked to Lamin A proteinsmay be used to prepare polyclonal and monoclonal antibodies againstthese proteins. Thereafter, these antibodies may be used to purifyproteins by immunoaffinity chromatography, in diagnostic assays toquantitate the levels of protein and to localize proteins in tissues andindividual cells by immunofluorescence.

Intact native protein may also be produced in E. coli in large amountsfor functional studies. Methods and plasmid vectors for producing fusionproteins and intact native proteins in bacteria are described inSambrook et al. (In Molecular Cloning: A Laboratory Manual, Ch. 17,CSHL, New York, 1989). Such fusion proteins may be made in largeamounts, are easy to purify, and can be used to elicit antibodyresponse. Native proteins can be produced in bacteria by placing astrong, regulated promoter and an efficient ribosome-binding siteupstream of the cloned gene. If low levels of protein are produced,additional steps may be taken to increase protein production; if highlevels of protein are produced, purification is relatively easy.Suitable methods are presented in Sambrook et al. (In Molecular Cloning:A Laboratory Manual, CSHL, New York, 1989) and are well known in theart. Often, proteins expressed at high levels are found in insolubleinclusion bodies. Methods for extracting proteins from these aggregatesare described by Sambrook et al. (In Molecular Cloning: A LaboratoryManual, Ch. 17, CSHL, New York, 1989). Vector systems suitable for theexpression of lacZ fusion genes include the pUR series of vectors(Ruther and Muller-Hill, EMBO J. 2:1791, 1983), pEX1-3 (Stanley andLuzio, EMBO J. 3:1429, 1984) and pMR100 (Gray et al., Proc. Natl. Acad.Sci. USA 79:6598, 1982). Vectors suitable for the production of intactnative proteins include pKC30 (Shimatake and Rosenberg, Nature 292:128,1981), pKK177-3 (Amann and Brosius, Gene 40:183, 1985) and pET-3(Studiar and Moffatt, J. Mol. Biol. 189:113, 1986). Lamin A fusionproteins may be isolated from protein gels, lyophilized, ground into apowder and used as an antigen. The DNA sequence can also be transferredfrom its existing context to other cloning vehicles, such as otherplasmids, bacteriophages, cosmids, animal viruses and yeast artificialchromosomes (YACs) (Burke et al., Science 236:806-812, 1987). Thesevectors may then be introduced into a variety of hosts including somaticcells, and simple or complex organisms, such as bacteria, fungi(Timberlake and Marshall, Science 244:1313-1317, 1989), invertebrates,plants (Gasser and Fraley, Science 244:1293, 1989), and animals (Purselet al., Science 244:1281-1288, 1989), which cell or organisms arerendered transgenic by the introduction of the heterologous LMNA cDNA.

For expression in mammalian cells, the cDNA sequence may be ligated toheterologous promoters, such as the simian virus (SV) 40 promoter in thepSV2 vector (Mulligan and Berg, Proc. Natl. Acad. Sci. USA 78:2072-2076,1981), and introduced into cells, such as monkey COS-1 cells (Gluzman,Cell 23:175-182, 1981), to achieve transient or long-term expression.The stable integration of the chimeric gene construct may be maintainedin mammalian cells by biochemical selection, such as neomycin (Southernand Berg, J. Mol. Appl. Genet. 1:327-341, 1982) and mycophenolic acid(Mulligan and Berg, Proc. Natl. Acad. Sci. USA 78:2072-2076, 1981).

DNA sequences can be manipulated with standard procedures such asrestriction enzyme digestion, fill-in with DNA polymerase, deletion byexonuclease, extension by terminal deoxynucleotide transferase, ligationof synthetic or cloned DNA sequences, site-directed sequence-alterationvia single-stranded bacteriophage intermediate or with the use ofspecific oligonucleotides in combination with PCR.

The cDNA sequence (or portions derived from it) or a mini gene (a cDNAwith an intron and its own promoter) may be introduced into eukaryoticexpression vectors by conventional techniques. These vectors aredesigned to permit the transcription of the cDNA in eukaryotic cells byproviding regulatory sequences that initiate and enhance thetranscription of the cDNA and ensure its proper splicing andpolyadenylation. Vectors containing the promoter and enhancer regions ofthe SV40 or long terminal repeat (LTR) of the Rous Sarcoma virus andpolyadenylation and splicing signal from SV40 are readily available(Mulligan et al., Proc. Natl. Acad. Sci. USA 78:1078-2076, 1981; Gormanet al., Proc. Natl. Acad. Sci USA 78:6777-6781, 1982). The level ofexpression of the cDNA can be manipulated with this type of vector,either by using promoters that have different activities (for example,the baculovirus pAC373 can express cDNAs at high levels in S. frugiperdacells (Summers and Smith, In Genetically Altered Viruses and theEnvironment, Fields et al. (Eds.) 22:319-328, CSHL Press, Cold SpringHarbor, N. Y., 1985) or by using vectors that contain promoters amenableto modulation, for example, the glucocorticoid-responsive promoter fromthe mouse mammary tumor virus (Lee et al., Nature 294:228, 1982). Theexpression of the cDNA can be monitored in the recipient cells 24 to 72hours after introduction (transient expression).

In addition, some vectors contain selectable markers such as the gpt(Mulligan and Berg, Proc. Natl. Acad. Sci. USA 78:2072-2076, 1981) orneo (Southern and Berg, J. Mol. Appl. Genet. 1:327-341, 1982) bacterialgenes. These selectable markers permit selection of transfected cellsthat exhibit stable, long-term expression of the vectors (and thereforethe cDNA). The vectors can be maintained in the cells as episomal,freely replicating entities by using regulatory elements of viruses suchas papilloma (Sarver et al., Mol. Cell Biol. 1:486, 1981) or Epstein-Ban(Sugden et al., Mol. Cell Biol. 5:410, 1985). Alternatively, one canalso produce cell lines that have integrated the vector into genomicDNA. Both of these types of cell lines produce the gene product on acontinuous basis. One can also produce cell lines that have amplifiedthe number of copies of the vector (and therefore of the cDNA as well)to create cell lines that can produce high levels of the gene product(Alt et al., J. Biol. Chem. 253:1357, 1978).

The transfer of DNA into eukaryotic, in particular human or othermammalian cells, is now a conventional technique. The vectors areintroduced into the recipient cells as pure DNA (transfection) by, forexample, precipitation with calcium phosphate (Graham and vander Eb,Virology 52:466, 1973) or strontium phosphate (Brash et al., Mol. CellBiol. 7:2013, 1987), electroporation (Neumann et al., EMBO J 1:841,1982), lipofection (Felgner et al., Proc. Natl. Acad. Sci USA 84:7413,1987), DEAE dextran (McCuthan et al., J. Natl. Cancer Inst. 41:351,1968), microinjection (Mueller et al., Cell 15:579, 1978), protoplastfusion (Schafner, Proc. Natl. Acad. Sci. USA 77:2163-2167, 1980), orpellet guns (Klein et al., Nature 327:70, 1987). Alternatively, thecDNA, or fragments thereof, can be introduced by infection with virusvectors. Systems are developed that use, for example, retroviruses(Bernstein et al., Gen. Engr'g 7:235, 1985), adenoviruses (Ahmad et al.,J. Virol. 57:267, 1986), or Herpes virus (Spaete et al., Cell 30:295,1982). Lamin A-encoding sequences, including sequences encoding mutantforms of Lamin A, can also be delivered to target cells in vitro vianon-infectious systems, for instance liposomes.

These eukaryotic expression systems can be used for studies of Lamin Aencoding nucleic acids and mutant forms of these molecules, the Lamin Aprotein and mutant forms of this protein. Such uses include, forexample, the identification of regulatory elements located in the 5′region of the LMNA gene on genomic clones that can be isolated fromhuman genomic DNA libraries using the information contained in thepresent disclosure. The eukaryotic expression systems may also be usedto study the function of the normal complete protein, specific portionsof the protein, or of naturally occurring or artificially producedmutant proteins.

Using the above techniques, the expression vectors containing the LMNAgene sequence or cDNA, or fragments or variants or mutants thereof, canbe introduced into human cells, mammalian cells from other species ornon-mammalian cells as desired. The choice of cell is determined by thepurpose of the treatment. For example, monkey COS cells (Gluzman, Cell23:175-182, 1981) that produce high levels of the SV40 T antigen andpermit the replication of vectors containing the SV40 origin ofreplication may be used. Similarly, Chinese hamster ovary (CHO), mouseNIH 3T3 fibroblasts or human fibroblasts or lymphoblasts may be used.

The present disclosure thus encompasses recombinant vectors thatcomprise all or part of the LMNA gene or cDNA sequences, for expressionin a suitable host. The LMNA DNA is operatively linked in the vector toan expression control sequence in the recombinant DNA molecule so thatthe Lamin A polypeptide can be expressed. The expression controlsequence may be selected from the group consisting of sequences thatcontrol the expression of genes of prokaryotic or eukaryotic cells andtheir viruses and combinations thereof. The expression control sequencemay be specifically selected from the group consisting of the lacsystem, the trp system, the tac system, the trc system, major operatorand promoter regions of phage lambda, the control region of fd coatprotein, the early and late promoters of SV40, promoters derived frompolyoma, adenovirus, retrovirus, baculovirus and simian virus, thepromoter for 3-phosphoglycerate kinase, the promoters of yeast acidphosphatase, the promoter of the yeast alpha-mating factors andcombinations thereof.

The host cell, which may be transfected with the vector of thisdisclosure, may be selected from the group consisting of E. coli,Pseudomonas, Bacillus subtilis, Bacillus stearothermophilus or otherbacilli; other bacteria; yeast; fungi; insect; mouse or other animal; orplant hosts; or human tissue cells.

It is appreciated that for mutant or variant LMNA DNA sequences, similarsystems are employed to express and produce the mutant product. Inaddition, fragments of the Lamin A protein can be expressed essentiallyas detailed above. Such fragments include individual Lamin A proteindomains or sub-domains, as well as shorter fragments such as peptides.Lamin A protein fragments having therapeutic properties may be expressedin this manner also.

Further, specifically contemplated are constructs that include a Lamin Aprotein, particularly a variant such as the provided mutant form,functionally linked to a tag. Examples of tags include generally epitopetags, purification tags, and identification tags. Specific examples ofpeptide tags include a FLAG tag, a c-myc tag, a 6×His tag, a HA tag, aT7 tag, a GFP peptide, and a GST peptide.

Example 8 Production of Lamin A Protein Specific Binding Agents

Monoclonal or polyclonal antibodies may be produced to either the normalLamin A protein or mutant forms of this protein. Optimally, antibodiesraised against these proteins or peptides would specifically detect theprotein or peptide with which the antibodies are generated, or in someinstances, a particular mutation form of that protein. That is, anantibody generated to the Lamin A protein or a fragment thereof wouldrecognize and bind the Lamin A protein and would not substantiallyrecognize or bind to other proteins found in human cells.

The determination that an antibody specifically detects the Lamin Aprotein is made by any one of a number of standard immunoassay methods;for instance, the Western blotting technique (Sambrook et al., InMolecular Cloning: A Laboratory Manual, CSHL, New York, 1989). Todetermine that a given antibody preparation (such as one produced in amouse) specifically detects the Lamin A protein by Western blotting,total cellular protein is extracted from human cells (for example,lymphocytes) and electrophoresed on a sodium dodecylsulfate-polyacrylamide gel. The proteins are then transferred to amembrane (for example, nitrocellulose) by Western blotting, and theantibody preparation is incubated with the membrane. After washing themembrane to remove non-specifically bound antibodies, the presence ofspecifically bound antibodies is detected by the use of an anti-mouseantibody conjugated to an enzyme such as alkaline phosphatase.Application of an alkaline phosphatase substrate5-bromo-4-chloro-3-indolyl phosphate/nitro blue tetrazolium results inthe production of a dense blue compound by immunolocalized alkalinephosphatase. Antibodies that specifically detect the Lamin A proteinwill, by this technique, be shown to bind to the Lamin A protein band(which will be localized at a given position on the gel determined byits molecular weight). Non-specific binding of the antibody to otherproteins may occur and may be detectable as a weak signal on the Westernblot. The non-specific nature of this binding will be recognized by oneskilled in the art by the weak signal obtained on the Western blotrelative to the strong primary signal arising from the specificantibody-Lamin A protein binding.

Substantially pure Lamin A protein or protein fragment (peptide)suitable for use as an immunogen may be isolated from the transfected ortransformed cells as described above. Concentration of protein orpeptide in the final preparation is adjusted, for example, byconcentration on an Amicon filter device, to the level of a fewmicrograms per milliliter. Monoclonal or polyclonal antibody to theprotein can then be prepared as follows:

A. Monoclonal Antibody Production by Hybridoma Fusion

Monoclonal antibody to epitopes of the Lamin A protein can be preparedfrom murine hybridomas according to the classical method of Kohler andMilstein (Nature 256:495-497, 1975) or derivative methods thereof.Briefly, a mouse is repetitively inoculated with a few micrograms of theselected protein over a period of a few weeks. The mouse is thensacrificed, and the antibody-producing cells of the spleen isolated. Thespleen cells are fused by means of polyethylene glycol with mousemyeloma cells, and the excess un-fused cells destroyed by growth of thesystem on selective media comprising aminopterin (HAT media). Thesuccessfully fused cells are diluted and aliquots of the dilution placedin wells of a microtiter plate where growth of the culture is continued.Antibody-producing clones are identified by detection of antibody in thesupernatant fluid of the wells by immunoassay procedures, such as ELISA,as originally described by Engvall (Meth. Enzymol. 70:419-439, 1980),and derivative methods thereof. Selected positive clones can be expandedand their monoclonal antibody product harvested for use. Detailedprocedures for monoclonal antibody production are described in Harlowand Lane (Antibodies, A Laboratory Manual, CSHL, New York, 1988).

B. Polyclonal Antibody Production by Immunization

Polyclonal antiserum containing antibodies to heterogeneous epitopes ofa single protein can be prepared by immunizing suitable animals with theexpressed protein, which can be unmodified or modified to enhanceimmunogenicity. Effective polyclonal antibody production is affected bymany factors related both to the antigen and the host species. Forexample, small molecules tend to be less immunogenic than others and mayrequire the use of carriers and adjuvant. Also, host animals vary inresponse to site of inoculations and dose, with either inadequate orexcessive doses of antigen resulting in low titer antisera. Small doses(ng level) of antigen administered at multiple intradermal sites appearto be most reliable. An effective immunization protocol for rabbits canbe found in Vaitukaitis et al. (J. Clin. Endocrinol. Metab. 33:988-991,1971).

Booster injections can be given at regular intervals, and antiserumharvested when antibody titer thereof, as determinedsemi-quantitatively, for example, by double immunodiffusion in agaragainst known concentrations of the antigen, begins to fall. See, forexample, Ouchterlony et al. (In Handbook of Experimental Immunology,Wier, D. (ed.) chapter 19. Blackwell, 1973). Plateau concentration ofantibody is usually in the range of about 0.1 to 0.2 mg/ml of serum(about 12 μM). Affinity of the antisera for the antigen is determined bypreparing competitive binding curves, as described, for example, byFisher (Manual of Clinical Immunology, Ch. 42, 1980).

C. Antibodies Raised Against Synthetic Peptides

A third approach to raising antibodies against a Lamin A protein orpeptides is to use one or more synthetic peptides synthesized on acommercially available peptide synthesizer based upon the predictedamino acid sequence of a Lamin A protein or peptide. Polyclonalantibodies can be generated by injecting these peptides into, forinstance, rabbits.

It is particularly contemplated that antibodies can be raised that arespecific for the variant/mutant protein provided herein. For instance,such variant-specific antibodies can be generated by using an epitopethat represents the abnormal junction between the middle of exon 11 andexon 12, as described herein. An immunogen of SGSGAQSPQNC (positions 601to 611 of SEQ ID NO: 7) would be an example. An antibody that recognizesthis epitope, but not wild type lamin A, can be used for a very specificdiagnostic test for HGPS. Even more than that, this antibody might beuseful as a therapeutic, since it would target the mutant protein andnot the normal one.

D. Antibodies Raised by Injection of Lamin A Encoding Sequence

Antibodies may be raised against Lamin A proteins and peptides bysubcutaneous injection of a DNA vector that expresses the desiredprotein or peptide, or a fragment thereof, into laboratory animals, suchas mice. Delivery of the recombinant vector into the animals may beachieved using a hand-held form of the Biolistic system (Sanford et al.,Particulate Sci. Technol. 5:27-37, 1987) as described by Tang et al.(Nature 356:152-154, 1992). Expression vectors suitable for this purposemay include those that express the Lamin A encoding sequence under thetranscriptional control of either the human β-actin promoter or thecytomegalovirus (CMV) promoter.

Antibody preparations, such as those prepared according to any of theseprotocols, are useful in quantitative immunoassays that determineconcentrations of antigen-bearing substances in biological samples; theyare also used semi-quantitatively or qualitatively to identify thepresence of antigen in a biological sample; or for immunolocalization ofthe Lamin A protein.

For administration to human patients, antibodies, e.g., Lamin A specificmonoclonal antibodies, can be humanized by methods known in the art.Antibodies with a desired binding specificity can be commerciallyhumanized (Scotgene, Scotland, UK; Oxford Molecular, Palo Alto, Calif.).

In addition, antibodies to Lamin A are commercially available. See, forinstance, Covance Research Products (CRP, Inc., Denver, Pa., USA)Catalog Number MMS-107R, a monoclonal antibody that recognizes bothLamin A and Lamin C.

Example 9 Protein-Based Diagnosis and Detection

An alternative method of detecting abnormalities in LMNA, including forinstance gene amplification, deletion or mutation, as well as abnormalLamin A expression, is to quantitate the level of Lamin A protein and/ordetermine its molecular weight in the cells of an individual. Thisdiagnostic tool would be useful for detecting reduced levels of theLamin A protein that result from, for example, mutations in the promoterregions of the LMNA gene or mutations within the coding region of thegene that produced truncated, non-functional or unstable polypeptides,as well as from deletions of a portion of or the entire LMNA gene.Alternatively, duplications of a Lamin A encoding sequence may bedetected as an increase in the expression level of Lamin A protein. Suchan increase in protein expression may also be a result of anup-regulating mutation in the promoter region or other regulatory orcoding sequence within the LMNA gene. Localization and/or coordinatedLamin A expression (temporally or spatially) can also be examined usingknown techniques, such as isolation and comparison Lamin A from cell ortissue specific, or time specific, samples.

The determination of reduced or increased Lamin A protein levels, incomparison to such expression in a control cell (e.g., normal, as intaken from a subject not suffering from progeria, such as HGPS), wouldbe an alternative or supplemental approach to the direct determinationof LMNA gene deletion, amplification or mutation status by the methodsoutlined above and equivalents.

The availability of antibodies specific to the Lamin A protein willfacilitate the detection and quantitation of cellular Lamin A by one ofa number of immunoassay methods which are well known in the art and arepresented in Harlow and Lane (Antibodies, A Laboratory Manual, CSHL, NewYork, 1988). Methods of constructing such antibodies are discussedabove, and Lamin-specific antibodies are available commercially.

Any standard immunoassay format (e.g., ELISA, Western blot, or RIAassay) can be used to measure Lamin A polypeptide or protein levels;comparison is to wild-type (normal) Lamin A levels, and an alteration inLamin A polypeptide may be indicative of an abnormal biologicalcondition such as progeria and/or a predilection to development of apremature aging disease or condition. Immunohistochemical techniques mayalso be utilized for Lamin A polypeptide or protein detection. Forexample, a tissue sample may be obtained from a subject, and a sectionstained for the presence of Lamin A using a Lamin A specific bindingagent (e.g., anti-Lamin A antibody) and any standard detection system(e.g., one which includes a secondary antibody conjugated to horseradishperoxidase). General guidance regarding such techniques can be found in,e.g., Bancroft and Stevens (Theory and Practice of HistologicalTechniques, Churchill Livingstone, 1982) and Ausubel et al. (CurrentProtocols in Molecular Biology, John Wiley & Sons, New York, 1998).

For the purposes of quantitating a Lamin A protein, a biological sampleof the subject (which can be any animal, for instance a mouse or ahuman), which sample includes cellular proteins, is required. Such abiological sample may be obtained from body cells, such as those presentin peripheral blood, urine, saliva, tissue biopsy, amniocentesissamples, surgical specimens and autopsy material, particularly breastcells. Quantitation of Lamin A protein can be achieved by immunoassayand compared to levels of the protein found in control cells (e.g.,healthy, as in from a patient known not to have progeria). A significant(e.g., 10% or greater) reduction in the amount of Lamin A protein in thecells of a subject compared to the amount of Lamin A protein found innormal human cells could be taken as an indication that the subject mayhave deletions or mutations in the LMNA gene, whereas a significant(e.g., 10% or greater) increase would indicate that a duplication(amplification), or mutation that increases the stability of the Lamin Aprotein or mRNA, may have occurred. Deletion, mutation and/oramplification of or within the Lamin A encoding sequence, andsubstantial under- or over-expression of Lamin A protein, may beindicative of progeria and/or a predilection to develop or carry anallele for a premature aging disease or condition.

Since it is predicted that Mutations 1 and 2 will produce a protein thatis 50 amino acids shorter than the wild type Lamin A, a convenientdiagnostic method to identify HGPS is to perform a Western blot and lookfor the abnormal (shorter) band.

Example 10 Differentiation of Individuals Homozygous Versus Heterozygousfor the Variant(s)

As will be appreciated by those of ordinary skill in the art, theoligonucleotide ligation assay (OLA), as described at Nickerson et al.(Proc. Natl. Acad. Sci. USA 87:8923-8927, 1990), allows thedifferentiation between individuals who are homozygous versusheterozygous for variant sequences in the LMNA gene, for instance eitherthe Mutation 1 or the Mutation 2 variants. This allows one to rapidlyand easily determine whether an individual is homozygous for at leastone progeria-linked variant or other polymorphism, which condition islinked to a relatively high predisposition to developing progeria and/oran increased likelihood of an age-related disease or condition, such asarthrosclerosis. Alternatively, OLA can be used to determine whether asubject is homozygous for a polymorphism identified in the LMNA gene.

As an example of the OLA assay, when carried out in microtiter plates,one well is used for the determination of the presence of the LMNAallele that contains a G at nucleotide position 1822 and a second wellis used for the determination of the presence of the LMNA allele thatcontains an A at nucleotide position 1822. Thus, the results for anindividual who is heterozygous for the polymorphism will show a signalin each of the G and A wells, and an individual who is homozygous forthe Mutation 2 polymorphism will show a signal in only the A well.

Example 11 Suppression of Lamin A Expression

A reduction of Lamin A protein expression in a cell may be obtained byintroducing into cells an antisense construct based on the LMNA encodingsequence, including the human LMNA cDNA or gene sequence (as shownherein) or flanking regions thereof. For antisense suppression, anucleotide sequence from an Lamin A encoding sequence, e.g. all or aportion of the LMNA cDNA or gene, is arranged in reverse orientationrelative to the promoter sequence in the transformation vector. Otheraspects of the vector may be chosen as discussed herein and are wellknown

The introduced sequence need not be the full length human LMNA cDNA orgene or reverse complement thereof, and need not be exactly homologousto the equivalent sequence found in the cell type to be transformed.Generally, however, where the introduced sequence is of shorter length,a higher degree of homology to the native LMNA sequence will be neededfor effective antisense suppression. The introduced antisense sequencein the vector may be at least 30 nucleotides in length, and improvedantisense suppression will typically be observed as the length of theantisense sequence increases. The length of the antisense sequence inthe vector advantageously may be greater than 100 nucleotides. Forsuppression of the LMNA gene itself, transcription of an antisenseconstruct results in the production of RNA molecules that are thereverse complement of mRNA molecules transcribed from the endogenousLMNA gene in the cell.

Although the exact mechanism by which antisense RNA molecules interferewith gene expression has not been elucidated, it is believed thatantisense RNA molecules bind to the endogenous mRNA molecules andthereby inhibit translation of the endogenous mRNA.

Expression of Lamin A can also be reduced using small inhibitory RNAs,for instance using techniques similar to those described previously(see, e.g., Tuschl et al., Genes Dev 13, 3191-3197, 1999; Caplen et al.,Proc. Nat'l Acad. Sci. USA 98, 9742-9747, 2001; and Elbashir et al.,Nature 411, 494-498, 2001). In particular, methods are contemplatedusing an RNAi that is targeted at the abnormal splice junction in mutantLamin A, which could shut off the abnormal protein and not the normalone.

Suppression of endogenous Lamin A expression can also be achieved usingribozymes. Ribozymes are synthetic RNA molecules that possess highlyspecific endoribonuclease activity. The production and use of ribozymesare disclosed in U.S. Pat. No. 4,987,071 to Cech and U.S. Pat. No.5,543,508 to Haselhoff. The inclusion of ribozyme sequences withinantisense RNAs may be used to confer RNA cleaving activity on theantisense RNA, such that endogenous mRNA molecules that bind to theantisense RNA are cleaved, which in turn leads to an enhanced antisenseinhibition of endogenous gene expression.

Finally, dominant negative mutant forms of Lamin A may be used to blockendogenous Lamin A activity. For instance, it is believed that mutant 1and mutant 2 as described herein are dominant negative mutations.

Example 12 LMNA Gene Therapy

Gene therapy approaches for combating or treating progeria, or reducingthe risk of premature aging disease or conditions, in subjects are nowmade possible by the present disclosure.

Retroviruses have been considered a preferred vector for experiments ingene therapy, with a high efficiency of infection and stable integrationand expression (Orkin et al., Prog. Med. Genet. 7:130-142, 1988). Thefull-length LMNA gene or cDNA can be cloned into a retroviral vector anddriven from either its endogenous promoter or from the retroviral LTR(long terminal repeat). Other viral transfection systems may also beutilized for this type of approach, including adenovirus,adeno-associated virus (AAV) (McLaughlin et al., J. Virol. 62:1963-1973,1988), Vaccinia virus (Moss et al., Annu. Rev. Immunol. 5:305-324,1987), Bovine Papilloma virus (Rasmussen et al., Methods Enzymol.139:642-654, 1987) or members of the herpesvirus group such asEpstein-Barr virus (Margolskee et al., Mol. Cell. Biol. 8:2837-2847,1988).

Gene therapy techniques include the use of RNA-DNA hybridoligonucleotides, as described by Cole-Strauss, et al. (Science273:1386-1389, 1996). This technique may allow for site-specificintegration of cloned sequences, thereby permitting accurately targetedgene replacement.

In addition to delivery of a Lamin A encoding sequence to cells usingviral vectors, it is possible to use non-infectious methods of delivery.For instance, lipidic and liposome-mediated gene delivery has recentlybeen used successfully for transfection with various genes (for reviews,see Templeton and Lasic, Mol. Biotechnol. 11:175-180, 1999; Lee andHuang, Crit. Rev. Ther. Drug Carrier Syst. 14:173-206; and Cooper,Semin. Oncol. 23:172-187, 1996). For instance, cationic liposomes havebeen analyzed for their ability to transfect monocytic leukemia cells,and shown to be a viable alternative to using viral vectors (de Lima etal., Mol. Membr. Biol. 16:103-109, 1999). Such cationic liposomes canalso be targeted to specific cells through the inclusion of, forinstance, monoclonal antibodies or other appropriate targeting ligands(Kao et al., Cancer Gene Ther. 3:250-256, 1996).

To reduce the level of Lamin A expression, gene therapy can be carriedout using antisense or other suppressive constructs, the construction ofwhich is discussed above.

Example 13 Kits

Kits are provided which contain the necessary reagents for determiningthe presence or absence of polymorphism(s) in a Lamin A-encodingsequence, such as probes or primers specific for the LMNA gene. Suchkits can be used with the methods described herein to determine whethera subject is predisposed to or heterozygous for progeria, or otherwiselikely to suffer from a premature aging disease or condition.

The provided kits may also include written instructions. Theinstructions can provide calibration curves or charts to compare withthe determined (e.g., experimentally measured) values. Kits are alsoprovided to determine elevated or depressed expression of mRNA (e.g.,containing probes) or Lamin A protein (e.g., containing antibodies orother Lamin A-protein specific binding agents).

A. Kits for Amplification of LMNA Sequences

The oligonucleotide probes and primers that can hybridize to a LMNAsequence, and particularly a sequence in or near exon 11 of LMNA, can besupplied in the form of a kit for use in detection of, for instance, apredisposition to progeria in a subject. In such a kit, an appropriateamount of one or more of the oligonucleotide primers is provided in oneor more containers. The oligonucleotide primers may be providedsuspended in an aqueous solution or as a freeze-dried or lyophilizedpowder, for instance. The container(s) in which the oligonucleotide(s)are supplied can be any conventional container that is capable ofholding the supplied form, for instance, microfuge tubes, ampoules, orbottles. In some applications, pairs of primers may be provided inpre-measured single use amounts in individual, typically disposable,tubes or equivalent containers. With such an arrangement, the sample tobe tested for the presence of an LMNA polymorphism can be added to theindividual tubes and amplification carried out directly.

The amount of each oligonucleotide primer supplied in the kit can be anyappropriate amount, depending for instance on the market to which theproduct is directed. For instance, if the kit is adapted for research orclinical use, the amount of each oligonucleotide primer provided wouldlikely be an amount sufficient to prime several PCR amplificationreactions. Those of ordinary skill in the art know the amount ofoligonucleotide primer that is appropriate for use in a singleamplification reaction. General guidelines may for instance be found inInnis et al. (PCR Protocols, A Guide to Methods and Applications,Academic Press, Inc., San Diego, Calif., 1990), Sambrook et al. (InMolecular Cloning: A Laboratory Manual, Cold Spring Harbor, N. Y.,1989), and Ausubel et al. (In Current Protocols in Molecular Biology,Greene Publ. Assoc. and Wiley-Intersciences, 1992).

A kit may include more than two primers, in order to facilitate the invitro amplification of LMNA sequences, for instance the LMNA gene or the5′ or 3′ flanking region thereof.

In some embodiments, kits may also include the reagents necessary tocarry out nucleotide amplification reactions, including, for instance,DNA sample preparation reagents, appropriate buffers (e.g., polymerasebuffer), salts (e.g., magnesium chloride), and deoxyribonucleotides(dNTPs).

Kits may in addition include either labeled or unlabeled oligonucleotideprobes for use in detection of LMNA polymorphism(s). In certainembodiments, these probes will be specific for a potential polymorphismthat may be present in the target amplified sequences. The appropriatesequences for such a probe will be any sequence that includes one ormore of the identified polymorphic sites, particularly nucleotidepositions 1822 and 1824, such that the sequence of the probe iscomplementary to a polymorphic site and the surrounding LMNA sequence.

It may also be advantageous to provide in the kit one or more controlsequences for use in the amplification reactions. The design ofappropriate positive control sequences is well known to one of ordinaryskill in the appropriate art.

B. Kits for Detection of LMNA mRNA Expression

Kits similar to those disclosed above for the detection of LMNApolymorphisms directly can be used to detect LMNA mRNA expression, suchas over- or under-expression. Such kits include an appropriate amount ofone or more oligonucleotide primers for use in, for instance, reversetranscription PCR reactions, similarly to those provided above withart-obvious modifications for use with RNA amplification.

In some embodiments, kits for detection of altered expression of LMNAmRNA may also include some or all of the reagents necessary to carry outRT-PCR in vitro amplification reactions, including, for instance, RNAsample preparation reagents (including e.g., an RNase inhibitor),appropriate buffers (e.g., polymerase buffer), salts (e.g., magnesiumchloride), and deoxyribonucleotides (dNTPs). Written instructions mayalso be included.

Such kits may in addition include either labeled or unlabeledoligonucleotide probes for use in detection of the in vitro amplifiedtarget sequences. The appropriate sequences for such a probe will be anysequence that falls between the annealing sites of the two providedoligonucleotide primers, such that the sequence of the probe iscomplementary to is amplified during the PCR reaction. In certainembodiments, these probes will be specific for a potential polymorphismthat may be present in the target amplified sequences, for instancespecific for the Mutation 1 allele (e.g., capable of detecting a Tresidue at position 1824 of the LMNA sequence).

It may also be advantageous to provide in the kit one or more controlsequences for use in the RT-PCR reactions. The design of appropriatepositive control sequences is well known to one of ordinary skill in theappropriate art.

Alternatively, kits may be provided with the necessary reagents to carryout quantitative or semi-quantitative Northern analysis of LMNA mRNA.Such kits include, for instance, at least one LMNA-specificoligonucleotide for use as a probe. This oligonucleotide may be labeledin any conventional way, including with a selected radioactive isotope,enzyme substrate, co-factor, ligand, chemiluminescent or fluorescentagent, hapten, or enzyme. In certain embodiments, such probes will bespecific for a potential polymorphism that may be present in the targetamplified sequences, for instance specific for the Mutation 1 allele(e.g., capable of detecting a T residue at position 1824 of the LMNAsequence).

C. Kits for Detection of Lamin A Protein Expression

Kits for the detection of Lamin A protein expression (such as over- orunder-expression, or expression of a protein of a different length thanfound in a normal cell) are also encompassed. Such kits may include atleast one target protein specific binding agent (e.g., a polyclonal ormonoclonal antibody or antibody fragment that specifically recognizesthe Lamin A protein) and may include at least one control (such as adetermined amount of Lamin A protein, or a sample containing adetermined amount of Lamin A protein). The Lamin A-protein specificbinding agent and control may be contained in separate containers.

The Lamin A protein expression detection kits may also include a meansfor detecting Lamin A:binding agent complexes, for instance the agentmay be detectably labeled. If the detectable agent is not labeled, itmay be detected by second antibodies or protein A for example which mayalso be provided in some kits in one or more separate containers. Suchtechniques are well known.

Additional components in specific kits may include instructions forcarrying out the assay. Instructions will allow the tester to determinewhether Lamin A expression levels are elevated. Reaction vessels andauxiliary reagents such as chromogens, buffers, enzymes, etc. may alsobe included in the kits.

D. Kits for Detection of Homozygous Versus Heterozygous Allelism

Also provided are kits that allow differentiation between individualswho are homozygous versus heterozygous for either the Mutation 1 or theMutation 2 polymorphisms of LMNA. Such kits provide the materialsnecessary to perform oligonucleotide ligation assays (OLA), as describedat Nickerson et al. (Proc. Natl. Acad. Sci. USA 87:8923-8927, 1990). Inspecific embodiments, these kits contain one or more microtiter plateassays, designed to detect polymorphism(s) in the LMNA sequence of asubject, as described herein.

Additional components in some of these kits may include instructions forcarrying out the assay. Instructions will allow the tester to determinewhether a LMNA allele is homozygous or heterozygous. Reaction vesselsand auxiliary reagents such as chromogens, buffers, enzymes, etc. mayalso be included in the kits.

It may also be advantageous to provide in the kit one or more controlsequences for use in the OLA reactions. The design of appropriatepositive control sequences is well known to one of ordinary skill in theappropriate art.

Example 14 Lamin A Knockout and Overexpression Transgenic Animals

Mutant organisms that under-express or over-express Lamin A protein areuseful for research. Such mutants allow insight into the physiologicaland/or pathological role of Lamin A in a healthy and/or pathologicalorganism, for instance in characterization of aging and aging-relateddiseases and conditions, including progeria. These mutants are“genetically engineered,” meaning that information in the form ofnucleotides has been transferred into the mutant's genome at a location,or in a combination, in which it would not normally exist. Nucleotidestransferred in this way are said to be “non-native.” For example, anon-LMNA promoter inserted upstream of a native LMNA encoding sequencewould be non-native. An extra copy of an LMNA gene on a plasmid,transformed into a cell, would be non-native.

Mutants may be, for example, produced from mammals, such as mice, thateither over-express Lamin A or under-express Lamin A, or that do notexpress Lamin A at all, or that express a mutant form of Lamin A (suchas the splice variant produced by the Mutation 1 allele describedherein). Over-expression mutants are made by increasing the number ofLMNA genes in the organism, or by introducing an LMNA gene into theorganism under the control of a constitutive or inducible or viralpromoter such as the mouse mammary tumor virus (MMTV) promoter or thewhey acidic protein (WAP) promoter or the metallothionein promoter.Mutants that under-express Lamin A may be made by using an inducible orrepressible promoter, or by deleting the LMNA gene, or by destroying orlimiting the function of the LMNA gene, for instance by disrupting thegene by transposon insertion.

Antisense “genes” or siRNA constructs may be engineered into theorganism, under a constitutive or inducible promoter, to decrease orprevent Lamin A expression, as discussed above.

A gene is “functionally deleted” when genetic engineering has been usedto negate or reduce gene expression to negligible levels. When a mutantis referred to in this application as having the LMNA gene altered orfunctionally deleted, this refers to the LMNA gene and to any orthologof this gene. When a mutant is referred to as having “more than thenormal copy number” of a gene, this means that it has more than theusual number of genes found in the wild-type organism, e.g., in thediploid mouse or human.

A mutant mouse over-expressing normal or mutant Lamin A may be made byconstructing a plasmid having an LMNA encoding sequence driven by apromoter, such as the mouse mammary tumor virus (MMTV) promoter or thewhey acidic protein (WAP) promoter. This plasmid may be introduced intomouse oocytes by microinjection. The oocytes are implanted intopseudopregnant females, and the litters are assayed for insertion of thetransgene. Multiple strains containing the transgene are then availablefor study.

WAP is quite specific for mammary gland expression during lactation, andMMTV is expressed in a variety of tissues including mammary gland,salivary gland and lymphoid tissues. Many other promoters might be usedto achieve various patterns of expression, e.g., the metallothioneinpromoter.

An inducible system may be created in which the subject expressionconstruct is driven by a promoter regulated by an agent that can be fedto the mouse, such as tetracycline. Such techniques are well known inthe art.

In particular, one example transgenic animal is a mouse model of HGPS,duplicating one of the G608G mutations. The mouse sequence is perfectlyidentical here, so this would produce the same kind of consequence forlamin A as in the human.

Example 15 Knock-in Organisms

In addition to knock-out systems, it is also beneficial to generate“knock-ins” that have lost expression of the wildtype protein but havegained expression of a different, usually mutant form of the sameprotein.

By way of example, the dominant mutant Lamin A protein provided hereincan be expressed in a knockout background, such as a mutant mouse thathas been rendered defective or selectively defective (e.g., induciblyknocked-out) for LMNA expression, in order to provide model systems forstudying the effects of the dominant mutant protein. In particularembodiments, the resultant knock-in organisms provide systems forstudying aging, arteriosclerosis, and/or HGPS-like conditions.

Those of ordinary skill in the relevant art know methods of producingknock-in organisms. See, for instance, Rane et al. (Mol. Cell Biol., 22:644-656, 2002); Sotillo et al. (EMBO J., 20: 6637-6647, 2001); Luo etal. (Oncogene, 20: 320-328, 2001); Tomasson et al. (Blood, 93:1707-1714, 1999); Voncken et al. (Blood, 86: 4603-4611, 1995); Andrae etal. (Mech. Dev., 107: 181-185, 2001); Reinertsen et al. (Gene Expr., 6:301-314, 1997); Huang et al. (Mol. Med., 5: 129-137, 1999) by way ofexample.

Example 16 Development of Therapeutic Compounds

This disclosure further relates in some embodiments to novel methods forscreening test compounds for their ability to treat, detect, analyze,ameliorate, reverse, and/or prevent diseases or conditions mediated bymutations in LMNA, and particularly dominant mutations such as Mutation1 and Mutation 2, which generate truncation mutant forms of Lamin A, andother mutations in LMNA. In particular, the present disclosure providesmethods for identifying test compounds that can be used to treat,ameliorate, reverse, and/or prevent aging-related or associated diseasesor conditions, including HGPS and other progeroid conditions anddiseases, arteriosclerosis and atherosclerosis.

The compounds of interest (which can be from any source, including butnot limited to combinatorial libraries, natural products, knowntherapeutic agents, small inorganic molecules, and so forth) can betested for instance by exposing the novel Lamin A variant describedherein, or another variant Lamin A protein, to the compounds, and if acompound inhibits one of the Lamin A variants, the compound is thenfurther evaluated for its anti-disease properties, such as its abilityto increase the number of divisions a cell can undergo in culture. Inspecific examples, the testing method is a high throughput method, forinstance an array-based and/or computer enabled method.

One aspect involves a screening method to identify a compound effectivefor treating, preventing, or ameliorating HGPS or an age-relatedcondition such as arteriosclerosis or atherosclerosis, which methodincludes ascertaining the compound's inhibition of a provided Lamin Avariant or another dominant negative Lamin A variant. In someembodiments, the screening method further includes determining whetherthe compound increases the growth or life of cells such as fibroblastsin a cell culture. In particular examples of such methods, the culturefibroblasts originated from a subject with HGPS; in others, they arefibroblasts obtained from a subject who is above a median or definedage, or from a subject in a family known to live to above a median ordefined age.

In other examples, the screening method includes examining themorphology of the nuclear membrane in cells (such as cells from orderived from a subject known to have progeria or a progeroid condition)treated with a compound of interest, to determine whether the compoundalters the morphology. Methods of observing nuclear membrane morphologyare well known to those of ordinary skill, and include but are notlimited to staining for lamins (e.g., using antibodies or other specificbinding agents) or for DNA (e.g., using DAPI). Compounds that make themorphology more like normal (e.g., more like that seen in a cell from asubject (or derived from a subject) known not to have progeria or aprogeroid condition) are then selected for further testing andevaluation.

By screening compounds in any of these fashions, potentially beneficialand improved compounds for treating age-related diseases and conditions,including HGPS and other progeroid diseases as well as arteriosclerosisand atherosclerosis, can be identified more rapidly and with greaterprecision than possible in the past.

This disclosure provides a link between mutations in the LMNA gene, andparticularly in Exon 11 of this gene, and the genetic disease HGPS.Other LMNA mutations are also identified that are linked to otherprogeroid conditions. The disclosure further provides methods ofdetecting, diagnosing, treating, and otherwise influencing progeria andother aging-related conditions, such as arteriosclerosis oratherosclerosis, based on the identification of alleles of the LMNAgene, or abnormalities in the expression of Lamin A. It will be apparentthat the precise details of the methods described may be varied ormodified without departing from the spirit of the described invention.We claim all such modifications and variations that fall within thescope and spirit of the claims below.

1. A substantially purified mutant human Lamin A protein, comprising anamino acid sequence as set forth in (a) SEQ ID NO: 7; (b) sequenceshaving at least 80% sequence identity to SEQ ID NO: 7 and containingMutation 1 (G608G(GGC>GGT)) or Mutation 2 (G608S(GGC>AGC)); (c) aconservative variant of (a) or (b) and containing Mutation 1(G608G(GGC>GGT)) or Mutation 2 (G608S(GGC>AGC)); (d) sequences having atleast 95% sequence identity to SEQ ID NO: 2 and comprising the variantE145K; (e) sequences having at least 95% sequence identity to SEQ ID NO:2 and comprising the variant R471C; (f) sequences having at least 95%sequence identity to SEQ ID NO: 2 and comprising the variant R527C; or(g) sequences having at least 95% sequence identity to SEQ ID NO: 2 andcomprising the variant A269V.
 2. The substantially purified mutant humanLamin A protein of claim 1, further comprising a heterologous peptidefused thereto.
 3. The substantially purified mutant human Lamin Aprotein of claim 1, further comprising a label.
 4. A monoclonal orpolyclonal antibody or fragment thereof that binds to a mutant humanLamin A protein of claim 1 but not to wildtype Lamin A (SEQ ID NO: 2).5. A mutant Lamin A protein-specific monoclonal or polyclonal antibodyor fragment thereof that binds to an epitope within the sequenceSGSGAQSPQNC (positions 601 to 611 of SEQ ID NO: 7) and not to an epitopein wildtype Lamin A (SEQ ID NO: 2).
 6. A kit for determining whether ornot a subject has Hutchinson-Gilford Progeria Syndrome (HGPS),arteriosclerosis, atherosclerosis, predisposition to arteriosclerosis,or predisposition to atherosclerosis by detecting a mutant Lamin aprotein in the subject, wherein determining whether the subject has amutant Lamin a protein comprises reacting at least one Lamin A proteincontained in a sample from the subject with a reagent comprising amutant Lamin A protein-specific binding agent to form a Lamin A:bindingagent complex and wherein the amino acid sequence of the mutant Lamin Aprotein comprises: (a) SEQ ID NO: 7; (b) a sequence having at least 95%sequence identity to SEQ ID NO: 7 and containing Mutation 1(G608G(GGC>GGT)) or Mutation 2 (G608S(GGC>AGC)); (c) a conservativevariant of (a) containing Mutation 1 (G608G(GGC>GGT)) or Mutation 2(G608S(GGC>AGC)); (d) sequences having at least 95% sequence identity toSEQ ID NO: 2 and comprising the variant E145K; (e) sequences having atleast 95% sequence identity to SEQ ID NO: 2 and comprising the variantR471C; (f) sequences having at least 95% sequence identity to SEQ ID NO:2 and comprising the variant R527C; or (g) sequences having at least 95%sequence identity to SEQ ID NO: 2 and comprising the variant A269V, thekit comprising: a container; and contained therein, the mutant LaminA-specific antibody of claim
 4. 7. A kit for determining whether or nota subject has Hutchinson-Gilford Progeria Syndrome (HGPS),arteriosclerosis, atherosclerosis, predisposition to arteriosclerosis,or predisposition to atherosclerosis by detecting a mutant Lamin aprotein in the subject, wherein determining whether the subject has amutant Lamin a protein comprises reacting at least one Lamin A proteincontained in a sample from the subject with a reagent comprising amutant Lamin A protein-specific binding agent to form a Lamin A:bindingagent complex the kit comprising: a container; and contained therein,the mutant Lamin A-specific antibody of claim
 5. 8. A kit fordetermining whether or not a subject has Hutchinson-Gilford ProgeriaSyndrome (HGPS), arteriosclerosis, atherosclerosis, predisposition toarteriosclerosis, or predisposition to atherosclerosis by detecting amutant Lamin A protein in the subject, the kit comprising a container,and contained therein, a mutant Lamin A protein-specific binding agent,wherein the mutant Lamin A protein-specific binding agent comprises anantibody that binds to an epitope within the sequence SGSGAQSPQNC(positions 601 to 611 of SEQ ID NO: 7) but not to an epitope in wildtypeLamin A (SEQ ID NO: 2).